Don’t take the risk, know more about your wrist!

Scaphoid fracture

The scaphoid is unique in that it spans the two rows of bones that make up your wrist.  Because of its position, it is the most commonly broken bone in the wrist.  Because symptoms can be minimal, scaphoid fractures are frequently mistaken as sprained wrists.  The patient frequently overlooks the fracture because it feels like a sprain. There is often only a little swelling and a variable amount of pain may be present. Usually, the swelling will go away in a few days.

Unlike the forearm, hand and finger bones, fractures of the scaphoid almost never show any obvious deformity of the wrist. These factors can make it common for the diagnosis to be delayed for weeks, months or occasionally even years after the initial injury because this injury can be overlooked and thought just to be a common wrist sprain. Scaphoid fractures require casting or surgery.

Where is the scaphoid?

The scaphoid bone is one of the eight smaller carpal bones in your wrist. It lies on the thumb side of your wrist right below the radius, one of the two larger bones in your forearm. It’s involved in moving and stabilizing your wrist.

You can find your scaphoid bone by holding your thumb up as you look at the back of your hand. The triangular indentation that’s formed by the tendons of your thumb is called the “anatomic snuffbox.” Your scaphoid is located at the bottom of this triangle.

Treatment option

If the fracture is identified immediately and is in good alignment, you will probably wear a cast for nine to twelve weeks. The cast will cover your forearm, wrist and thumb. This is necessary to hold the scaphoid bone very still while it heals. Your doctor will take x-rays at least once a month to check the progress of the healing. Once your doctor is sure the fracture has healed, the cast will be removed. Even with this type of treatment, there is still a risk that the fracture may not heal well and will become a non-union.

For nonunion fractures, surgery with bone grafting is required where there’s a long time between the fracture and nonunion, the fractured bone ends aren’t close together, or the blood supply is poor.

My Xray report shows delayed union.

Delayed union: the fracture hasn’t completely healed after four months

Fracture of the scaphoid bone is the most common fracture of the carpus, and frequently, diagnosis is delayed. The unique anatomy and blood supply of the scaphoid itself predisposes to delayed union or nonunion.

How can physiotherapy help with scaphoid fracture?

People with scaphoid fractures usually require the help of a physiotherapist to overcome the stiffness that develops in their thumb and wrist joints, and the weakness in their hand that comes from a period of immobilization in the cast or splint.

Exercise

• You will be given a set of graduated exercises designed to regain your full movement and wrist strength.

Mobilization and soft tissue techniques

• You may have reduced movement in your wrist and thumb, requiring correction through mobilization and soft tissue techniques.

Return-to-sport and work

• The timing of your return to sport or work will depend upon your progress and the physical demands that will be placed upon your wrist.

Don’t take the risk, talk to your doctor if the pain is getting severe