Scaphoid Wrist
Fracture
Introduction
The
scaphoid is one of the small bones in the wrist (carpal bones),
and the one that is most likely to break. The scaphoid is
a kidney shaped bone and sits below the thumb (refer to figure
1) A scaphoid fracture often occurs when a individual falls
on an outstretched arm. The scaphoid which is also known as
the navicular is damaged.
Scaphoid
fractures account for about 60 percent of all wrist (carpal)
fractures. They usually occur in men between ages 20 and 40
years, and are less common in children or in older adults.
The break usually occurs during a fall on the outstretched
wrist. It’s a common injury in sports and motor vehicle
accidents. The angle at which the wrist hits the ground determines
the injury. If the wrist is bent at a 90-degree angle or greater,
the scaphoid bone will break; if the angle is less than 90
degrees, the lower arm bone (radius) will break.
It
has its own blood supply which is why a fracture can damage
this blood supply causing delayed or no healing to the fracture.
A complete loss of blood supply to the bone can cause death
to the bone. This condition is called avascular necrosis (Avascular
means no blood supply, and necrosis means dead.).
Often
patients present with wrist pain following a fall and the
x-ray does not immediately show damage to the scaphoid. Persistent
pain and follow up x-rays can be required to correctly diagnose
the condition.
Symptoms
The symptoms
of a fresh fracture of the scaphoid bone usually include pain
in the wrist and tenderness in the area just below the thumb.
You may also see swelling around the wrist. The swelling occurs
because blood from the fractured bone fills the wrist joint.
Thin people will see a bulging of the joint capsule. The joint
capsule is the watertight sac that encloses the joint.
Pain
may subside, then return as a deep, dull aching and gripping
anything may be painful.
Treatment
- Casting
for 9 to 12 weeks. This is necessary to hold the scaphoid
bone very still while it heals.
- Surgery
such as screw fixation, scaphoid debridement and bone grafting.
Rehabilitation
The amount
of time the patient needs to wear the cast depends on what
part is fractured and whether the bones heal well. When your
doctor is certain the bones have healed, the cast will be
removed. The wrist will probably be stiff and weak from being
in the cast.
Following
the casting it is recommended to wear a wrist support and
carry out wrist strengthening exercises to help strengthen
and stabilize the muscles around the wrist joint.
Recommended
Products for Scaphoid Wrist Fractures
Wrist
Brace
Designed
to limit movement after a fracture. Features a removable aluminum
splint.
Pro
Lite Wrist Splint
The Pro Lite is wrist splint is ideal for weak wrists after
cast removal. Stabilizes the wrist while still allowing full
movement of the fingers
View
other wrist braces
