Wrist Fracture: Scaphoid

What is a scaphoid wrist fracture?

A scaphoid wrist fracture is a crack or break in the bone called the scaphoid bone in your wrist. There are 8 bones in the wrist. The navicular, or scaphoid, bone is near the thumb. Sometimes fractures of this bone are slow to heal because the bone doesn’t have a good blood supply.

This type of fracture is also called a navicular fracture.

What is the cause?

The usual causes of a wrist fracture are:

• a fall
• a direct hit to the wrist

What are the symptoms?

Symptoms may include:

• pain, swelling, or tenderness usually just below the thumb
• bruising
• trouble moving the wrist

How is it diagnosed?

Your provider will ask about your symptoms and how the injury happened. He or she will examine you. You will have X-rays of your wrist. Sometimes you may also have a CAT scan or bone scan.

How is it treated?

Your healthcare provider will put your arm and wrist in a cast that includes your thumb. You will wear the cast for up to 12 weeks or longer to be sure the bone heals.

Sometimes, if the wrist doesn’t heal and the pieces of bone don’t grow back together, you may have a problem called avascular necrosis. This means that part of the bone has died because it did not get enough blood. Then you may need surgery to remove part of the injured bone or put in an artificial bone. To help the bone heal, you may have a bone graft using a small piece of bone from another part of your body or a piece of manmade material.

How can I take care of myself?

Follow the full course of treatment your healthcare provider prescribes. Also:

• To keep swelling down and help relieve pain, your healthcare provider may tell you to:
  • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time for the first day or two after the injury.
  • Keep the injured wrist up on pillows when you sit or lie down.
  • Take pain medicine, such as ibuprofen, as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• If you have a cast, make sure the cast does not get wet. Cover the cast with plastic when you bathe. Avoid scratching the skin around the cast or poking things down the cast. This could cause an infection.

When your arm has been in a cast, your joints may get stiff and your muscles get weaker. After the cast is removed, your healthcare provider or physical therapist may recommend exercises to help your arm get stronger and more flexible. Follow your provider’s instructions for doing exercises.

Keep all appointments for provider visits or tests. Call your healthcare provider right away if:

• You have more pain, redness, warmth, or swelling.
• You have a fever higher than 101.5°F (38.6°C).
• You have a loss of feeling in the injured area.
• The injured area looks pale or blue or feels cold.

How long will the effects last?

Scaphoid fractures may take 6 to 12 weeks or longer to heal. Your wrist may heal completely or you may have some permanent stiffness or loss of range of motion.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your normal activities depends on how soon your wrist recovers, not by how many days or weeks it has been since your injury has occurred. The goal is to return to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may return to your normal activities when you have full range of motion in your wrist without pain. Your injured wrist, hand, and forearm need to have the same strength as the uninjured side. If you return to using your wrist too soon after a navicular fracture there could be problems with healing. It is very important to be sure that none of your activities cause wrist pain or tenderness.

How can I prevent a scaphoid fracture?

A wrist fracture usually occurs during an accident that is not easy to prevent. When you do activities like skating, be sure to wear protective wrist guards.