Scaphoid fracture
A scaphoid fracture is a break of the scaphoid bone in the wrist. Symptoms generally includes pain at the base of the thumb which is worse with use of the hand. The anatomic snuffbox is generally tender and swelling may occur. Complications may include nonunion of the fracture, avascular necrosis of the proximal part of the bone, and arthritis.
| Scaphoid fracture | |
|---|---|
| Other names | Carpal scaphoid fracture, carpal navicular fracture |
| An X-ray showing a fracture through the waist of the scaphoid | |
| Specialty | Hand surgery, emergency medicine |
| Symptoms | Pain at the base of the thumb, swelling |
| Complications | Nonunion, avascular necrosis, arthritis |
| Types | Proximal, medial, distal |
| Causes | Fall on an outstretched hand |
| Diagnostic method | Examination, X-rays, MRI, bone scan |
| Differential diagnosis | Distal radius fracture, De Quervain's tenosynovitis, scapholunate dissociation, wrist sprain |
| Prevention | Wrist guards |
| Treatment | Not displaced: Cast Displaced: Surgery |
| Prognosis | Healing may take up to six months |
Scaphoid fractures are most commonly caused by a fall on an outstretched hand. Diagnosis is generally based on a combination of clinical examination and medical imaging. Some fractures may not be visible on plain X-rays. In such cases the affected area may be immobilised in a splint or cast and reviewed with repeat X-rays in two weeks, or alternatively an MRI or bone scan may be performed.
The fracture may be preventable by using wrist guards during certain activities. In those in whom the fracture remains well aligned a cast is generally sufficient. If the fracture is displaced then surgery is generally recommended. Healing may take up to six months.
It is the most commonly fractured carpal bone. Males are affected more often than females.