Scaphoid Fractures

Hand Surgeon Mark E. Pruzansky, MD and Jason S. Pruzansky, MD can help you experience less pain and recover quicker from hand, wrist and elbow surgery through minimally invasive surgery techniques. Call our Concierge Services at 212-249-8700 to schedule your appointment.

What is a Scaphoid Fracture?

The scaphoid is one of the eight small carpal bones in your wrist joint and is on the thumb side.  It looks like a twisted peanut.  The scaphoid is very important for normal wrist movement, but it is also the most common carpal bone to fracture.

Symptoms of a Scaphoid Fracture

A scaphoid fracture causes pain, swelling, bruising, stiffness, and difficulty moving the wrist.  Sometimes the pain and swelling may not be severe and the injury may be mistaken as a wrist sprain.

Common Causes of a Scaphoid Fracture

A Scaphoid Fracture can occur from a fall onto an outstretched hand during skiing, snowboarding, skating, football, basketball, or while walking.  Car accidents can result in a scaphoid fracture as well.

Diagnosing a Scaphoid Fracture

Speaking with you to understand the details of how your injury occurred is important.  A careful physical exam is essential to identify the injured structure and any associated injuries.  An x-ray will evaluate the scaphoid and the rest of the wrist for fracture.  The scaphoid can be fractured in different locations along the length of the bone, and knowing the location of the fracture can be important in determining optimum treatment.  An MRI or CT scan will sometimes be obtained if the x-ray is not clearly demonstrating a fracture of the scaphoid, but there is still clinical concern for such an injury.

Treatment Options for Scaphoid Fracture

Scaphoid Fractures that just involve a crack in the bone without movement of the fractured parts away from each other (Non-displaced) can be treated usually with cast immobilization.  A scaphoid fracture that has moved apart (Displaced) will benefit from surgery to realign the bone and insert a small screw to stabilize the fracture while it heals, as the risk of non-healing is significant in scaphoid fractures.  A scaphoid fracture at its proximal pole has poor blood supply and may not heal with just a cast, so this kind of scaphoid fracture is a candidate for minimally invasive screw fixation.  Additionally, a non-displaced scaphoid fracture can be treated with minimally invasive screw fixation as it may reduce total immobilization time and non-union rates and lead to a shorter convalescence.  This may be an attractive alternative for athletes and other individuals.

A chronic scaphoid fracture that has not healed may be treated with surgery involving screw fixation and vascularized bone graft to generate healing.

Conclusion

A Scaphoid Fracture requires prompt diagnosis and treatment to obtain adequate healing, as the bone’s weak blood supply can lead to non-healing and arthritis of the wrist joint.  Call Dr. Pruzansky at 212-249-8700 to schedule an appointment.