Scaphoid Fracture

By: Julia Guthart, OTR/L, CHT

Where is the Scaphoid Bone?

The Scaphoid Bone is the most proximal and lateral of the carpal bones. It sits below the anatomical “snuffbox” of the wrist which is below your thumb. When people used to snort “snuff” instead of “vaping” like now-a-days, they used a little indentation at the junction of the base of the thumb and wrist, therefore this area became known as the “snuffbox.” Fractures of the scaphoid bones are the most common carpal bone fractures.

The wrist joint is made up of the distal radius and ulna in your forearm, and 8 carpal bones or wrist bones. They look like little stones and are arranged in two rows. These 8 bones shift and glide a bit during wrist flexion and extension. If there is a fracture, it often does not appear on x-ray. 

X-ray image of a scaphoid fracture in the right wrist with label to show the fracture

What is Unique About Scaphoid Fractures?

There are several levels of severity of scaphoid fractures. If the blood supply is interrupted, the scaphoid bone fails to heal. Making this the most severe of scaphoid fractures. If you are walking around living with a scaphoid that has not healed, eventually the bone fragments spread, and you end up with severe arthritis and pain. Sometimes the ligament holding the scaphoid to the lunate is disrupted from a fall or injury. This also leads to spreading, if left untreated, and severe arthritic changes.

Symptoms of a Scaphoid Fracture

Symptoms of a scaphoid fracture are swelling and pain over the wrist on the thumb side. Often you can still move your wrist up and down, so you may think it is not broken. If this pain persists, an X-ray is an important first step in diagnosing this fracture. Many times, an MRI or CT scan is used to isolate the scaphoid fracture and for the definitive diagnosis.

How Do You Treat a Scaphoid Fracture?

Scaphoid fractures take a long time to heal due to poor blood supply. They are immobilized in a thumb spica splint; or in the most severe fracture cases, surgical fixation and repair of blood vessels is needed. 

After surgery, the scaphoid is immobilized in a splint or cast. Movement of the wrist after surgery can disrupt the intricate blood vessel repair and slow the healing of the fracture.

Occupational or Physical Therapy are often indicated after a scaphoid fracture to regain mobility and function. The immobilization in a cast or splint can make the area very stiff and limited in function.

Click here to learn about ActivArmor Casting for Fractures.

Related Links:

If you have a wrist injury or if you think you may have a Scaphoid Fracture, the Jacksonville Orthopaedic Institute can help. To see a JOI Orthopedic Wrist and Hand Specialist, call (904)JOI-2000, schedule online, or click the link below. To see a JOI Rehab Certified Hand Therapist, call (904)858-7045



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