Scaphoid Fractures

What are Scaphoid Fractures?

A scaphoid (navicular) fracture is a break in one of the small bones of the wrist. This type of fracture occurs most often after a fall onto an outstretched hand. Symptoms of a scaphoid fracture typically include pain and tenderness in the area just below the base of the thumb.

What is the Cause of Scaphoid Fractures?

A scaphoid fracture usually occurs when you fall onto an outstretched hand, with your weight landing on your palm. The end of the larger forearm bone (the radius) may also break in this type of fall, depending on the position of the hand on landing.

The injury can also happen during sports activities or motor vehicle collisions.

Fractures of the scaphoid occur in people of all ages, including children. There are no specific risk factors or diseases that make you more likely to experience a scaphoid fracture. Some studies have shown that using wrist guards during high-energy activities like inline skating and snowboarding can help decrease your chance of breaking a bone around the wrist.

What are the Symptoms of Scaphoid Fractures?

Scaphoid fractures usually cause pain and swelling in the anatomic snuffbox and on the thumb side of the wrist. The pain may be severe when you move your thumb or wrist, or when you try to pinch or grasp something.

Unless your wrist is deformed, it might not be obvious that your scaphoid bone is broken. With some scaphoid fractures, the pain is not severe and may be mistaken for a wrist sprain.

Pain in your wrist that does not go away within a day of injury may be a sign of a fracture—so it is important to see a doctor if your pain persists. Prompt treatment of a scaphoid fracture will help avoid potential complications.

What are the Treatments for Scaphoid Fractures?

The treatment your doctor at Select Orthopedic Specialists recommends will depend on a number of factors, including:
• The location of the break in the bone
• Whether the bone fragments are displaced
• How long ago your injury occurred

Nonsurgical Treatment

Fracture near the thumb. Scaphoid fractures that are closer to the thumb (distal pole) usually heal in a matter of weeks with proper protection and restricted activity. This part of the scaphoid bone has a good blood supply, which is necessary for healing.

For this type of fracture, your doctor may place your forearm and hand in a cast or a splint. The cast or splint will usually be below the elbow and include your thumb.

Healing time varies from patient to patient. Your doctor will monitor your healing with periodic x-rays or other imaging studies.

Fracture near the forearm. If the scaphoid is broken in the middle of the bone (waist) or closer to the forearm (proximal pole), healing can be more difficult. These areas of the scaphoid do not have a very good blood supply.

These fracture can either be treated with or without surgery depending on the type of fracture. If your doctor treats this type of fracture with a cast, the cast may include the thumb and extend above the elbow to help stabilize the fracture.

Bone stimulator. In some cases, your doctor may recommend the use of a bone stimulator to assist in fracture healing. This small device delivers low-intensity ultrasonic or pulsed electromagnetic waves that stimulate healing.

Surgical Treatment

If your scaphoid is broken at the waist or proximal pole or if pieces of bone are displaced, your doctor may recommend surgery. The goal of surgery is to realign and stabilize the fracture, giving it a better chance to heal.

Reduction. During this procedure, your doctor will administer an anesthetic or anesthesia and manipulate the bone back into its proper position. In some cases, this is done using a limited incision and special guided instruments. In other cases, it is performed through an open incision with direct manipulation of the fracture. For some fractures, your doctor may use a tiny camera called an “arthroscope” to aid in the reduction.

Internal fixation. During this procedure, metal implants—including screws and/or wires—are used to hold the scaphoid in place until the bone is fully healed.
The location and size of the surgical incision depends on what part of the scaphoid is broken. Sometimes, the screw or wire can be placed in bone fragments with a small incision. In other cases, a larger incision is needed to ensure that the fragments of the scaphoid line up properly. The incision may be made on either the front or the back of your wrist.

Select Orthopedic Los Angeles

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Downtown Los Angeles: 1245 Wilshire Blvd #717
Los Angeles, CA90017

 

Culver City: 4173 Inglewood blvd. Suite 300
Culver City,CA90066

Phone: 213-935-8566
selectorthopedic.com

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