Scaphoid injuries: Understanding diagnosis and treatment

A scaphoid injury refers to a fracture of the scaphoid bone, one of the small carpal bones located on the thumb side of the wrist. This type of injury commonly occurs due to a fall onto an outstretched hand and is particularly prevalent in sports or activities where falls are common, such as skateboarding or football. Here to provide an expert look at this topic is highly-respected consultant hand and wrist surgeon Miss Alice Bremner-Smith.

How is a scaphoid injury diagnosed?

Diagnosis of a scaphoid injury can be challenging because the symptoms may be subtle and easily mistaken for a simple sprain. Patients often experience pain and swelling on the thumb side of the wrist, but this may not be immediately severe.

To accurately diagnose a scaphoid fracture, the following steps are typically taken:

• Physical examination: A doctor will examine the wrist for tenderness, particularly in the anatomical snuffbox, which is a small depression at the base of the thumb.
• X-rays: Initial X-rays may not always detect a scaphoid fracture, especially if the bone has not yet displaced. Therefore, doctors may request additional imaging, such as:
• MRI or CT scan: These more detailed imaging techniques can provide clearer images and help confirm the presence of a fracture that may not be visible on X-ray.

Treatment options for scaphoid fractures

Treatment depends on the severity and location of the fracture, with options ranging from non-surgical to surgical interventions.

• Non-surgical treatment: For minor fractures where the bone is not displaced, treatment may involve immobilising the wrist in a cast for 6 to 12 weeks. This allows the bone to heal naturally.
• Surgical treatment: In cases where the fracture is displaced or if non-surgical treatment does not promote healing, surgery may be necessary. The procedure typically involves fixing the bone with screws or pins to ensure proper alignment and promote healing.

Healing and recovery

The scaphoid bone has a limited blood supply, particularly in its upper portion, which can complicate healing and lead to delayed or incomplete recovery. In some cases, even with treatment, a condition called non-union may occur, where the bone fails to heal properly, potentially requiring further surgery.

Early diagnosis and appropriate treatment are crucial for a full recovery. Prolonged wrist pain following a fall should not be ignored, and seeking medical advice is essential to prevent long-term complications.

Experiencing wrist pain and think it could be a scaphoid injury, or another hand and wrist condition? Arrange a consultation with Miss Bremner-Smith to pinpoint what’s going on, via her Top Doctors profile.