Scaphoid Fracture

A scaphoid fracture is a kind of broken wrist. It happens when you break the small scaphoid bone near the base of your thumb. The scaphoid is part of your carpal bones — the collection of bones that form your wrist joint.

Scaphoid fractures are some of the most common broken bones. They usually happen when you fall on your hands with your arms stretched out in front of you.

Types of scaphoid fractures

A healthcare provider might describe a scaphoid fracture with a more specific name, depending on where your bone is broken:

• Distal pole scaphoid fracture: The fracture is closest to your hand and fingers (pointing away from your forearm).
• Scaphoid waist fracture: The fracture is in the middle part of the bone. This is the most common type.
• Proximal pole scaphoid fracture: The end closest to your forearm (pointing in toward your body) is fractured.

Your provider may also call the fracture displaced or non-displaced. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke. A non-displaced fracture is still a broken bone, but the pieces didn’t move far enough to be out of alignment during the break. Displaced fractures are much more likely to require surgery to repair.

Scaphoid fracture symptoms

Scaphoid fracture symptoms include:

• Pain
• Swelling
• Tenderness
• Not being able to move your wrist
• Bruising or discoloration
• A deformity or bump that’s not usually on your wrist

Scaphoid fracture causes

Any hard, sudden impact to your wrist can break your scaphoid. Common causes include:

• Falls, especially catching yourself with outstretched arms after you slip or trip
• Sports injuries
• Car accidents

Complications of scaphoid fractures

Like all broken bones, scaphoid fractures can lead to complications, especially if they’re not treated right away. Complications can include:

• Compartment syndrome
• Malunion or nonunion
• Avascular necrosis (osteonecrosis)
• Post-traumatic arthritis

How doctors diagnose scaphoid fractures

A healthcare provider will diagnose a scaphoid fracture with a physical exam and some imaging tests. They’ll examine your hand and wrist. Tell your provider what you were doing before you noticed symptoms, or if you know you had a fall or sports injury.

Your provider can use a few tests to diagnose a scaphoid fracture, including:

• X-rays
• MRI
• CT scan

Some scaphoid fractures don’t show up well (or at all) on X-rays. These are called occult scaphoid fractures. Your healthcare provider might need you to get an MRI or CT scan in addition to X-rays. They’ll let you know which other imaging tests you’ll need.

Scaphoid fracture treatments

The treatments you need depend on the fracture’s severity, and if you have any other injuries. Your provider will suggest a combination of:

• Immobilization: Wearing a splint or cast will hold your wrist stable so your bone can heal together correctly. This can take anywhere from a few weeks to a few months. You’ll need immobilization after other treatments, too.
• Closed reduction: Your provider may need to realign your bone by pushing and pulling your hand and wrist to set your scaphoid to the correct position. They’ll give you an anesthetic so you won’t feel pain.
• Surgery: Severe breaks may need surgery, usually an open reduction and internal fixation (ORIF). Your surgeon will realign your bone and insert fasteners like pins, wires or screws to hold it together. You may need a follow-up procedure to remove these fasteners after you heal.
• Bone grafts: It’s rare to need a graft procedure. But you might if the fracture is severely displaced or your scaphoid doesn’t heal correctly. A surgeon will insert donated bone to rejoin your broken bone.

When should I seek care?

Go to the emergency room if you think you have a broken bone. Don’t try to move or use your wrist.

Call your local emergency services number if you experience a trauma like a car accident or severe fall.

Your healthcare provider will tell you when you’ll need follow-up X-rays as you heal. They’ll make sure your scaphoid bone is healing back together like it should.

Scaphoid fracture recovery time

Most people need around three months to recover from a scaphoid fracture. How long it takes you to heal depends on the fracture’s severity and which treatments you needed.

You’ll probably need physical therapy to help regain strength and mobility in your wrist.

Lots of factors can affect healing time. Talk to your provider or surgeon about a timeline that fits your specific situation.