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The scaphoid bone is one of the carpal bones on the thumb side of the wrist. This bone is important for both motion and stability in the wrist joint, and it can most easily be identified when your thumb is held in a “hitch-hiking” position.
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 (e.g., 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.
It’s impossible to prevent the sudden events that often cause a scaphoid fracture of the wrist. However, some studies have shown that using wrist guards during high-energy activities, like inline skating and snowboarding, can help to lower your chance of breaking a bone around the wrist.
Scaphoid fractures usually cause pain and swelling at the base of the thumb. 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 one 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 you to avoid potential complications.
During the physical examination, your doctor will want to know how your injury occurred. With most fractures, there will be tenderness at the base of your thumb. Your doctor will also look for swelling, bruising and loss of motion. An X-ray of the wrist usually diagnoses scaphoid fractures; however, X-rays do not always show scaphoid fractures. If you are tender directly over the scaphoid bone, which is located in the hollow at the thumb side of the wrist, your health care provider might recommend wearing a splint to be safe. If pain persists, a follow-up exam and X-ray in a week or two can be used to diagnose. Even more, your doctor may order an MRI to confirm diagnosis, and to learn more about the bones and soft tissues in your wrist. An MRI can often show a fracture of the scaphoid before it can be seen on an X-ray.
The treatment that your doctor recommends will depend on a number of factors, including the location of the break in the bone, whether the bone fragments are displaced, and how long ago your injury occurred. Scaphoid fractures that are closer to the thumb usually heal with proper protection and restricted activity. For these types of fractures, your doctor will place your forearm and hand in a cast or a splint for a few weeks. If your scaphoid is broken at the waist or the area closer to the wrist joint, 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 since blood supply to the proximal end of the scaphoid bone is poor and has difficulty healing.