1. Breaking a Scaphoid Bone
The scaphoid is one of the eight carpal bones that allow your hand and wrist to be so flexible. Because of its location, it is the carpal bone most often broken, which usually happens when you put your hands out to break a fall.
2. Not Always Easy to Diagnose
Though scaphoid fractures are relatively common, they aren't always obvious. You may think it's only a sprain, because you can't see any obvious injury, and you may have limited pain and swelling around the base of your thumb after your injury. Even an x-ray may not show a scaphoid fracture that isn't displaced, that is, separated at the break, for up to several weeks after the bone is broken. That's why your doctor may recommend an MRI, bone scan or even prophylactic casting to keep any possible fracture in place, allowing it to heal.
3. Treating a Scaphoid Fracture
Because a scaphoid fracture isn't always diagnosed when it first happens, it might not heal well or at all. Even if your scaphoid fracture is discovered right away, whether it is casted or surgically repaired depends on where the bone is broken, if it is displaced or not and how much damage there is to the surrounding structures.
Like all bones, the scaphoid depends on a good blood supply for healing. If you break the bone in such a way that it damages the blood supply, you might end up with a non-union or avascular necrosis, a condition that could lead to traumatic arthritis as the bone dies.
A non-union fracture can also happen if a scaphoid fracture isn't discovered for weeks, months or even years after it occurs. The parts of the bone that were broken heal separately, rather than being knit back together, which can lead to arthritis.
It's possible to get avascular necrosis or a non-union fracture in spite of early diagnosis and casting, so you may need surgery, which could mean either a bone graft or having a screw inserted to hold the parts of the fracture together while they heal.
4. Returning to Play
You will need to have your wrist immobilized in a cast for a while after a scaphoid fracture, whether or not you have it surgically repaired. Because immobilization leads to weakness and stiffness, most doctors try to limit the time you're in a cast or splint. Still, some people end up with the joint immobilized for months. While you're in healing mode, don't do a lot of heavy lifting or climbing, and try not to fall on the injured hand. Once the cast or splint is removed, therapy will help mobilize and strengthen the hand and wrist. While there are casts that allow you an early return to the playing field, talk to your doctor about resuming any activity that may lead to additional trauma to your wrist.
