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Scaphoid Fracture


Scaphoid fractures are one of the common injuries affecting the wrist.

The scaphoid is a one of the small carpal bones in the wrist which is important for movement, stability and function. The scaphoid has a peculiar blood supply.

Scaphoid fractures most commonly occur in young males as a result of fall on an outstretched hand.

Scaphoid fractures can sometimes be missed or misdiagnosed as a ‘sprained wrist’. Scaphoid fractures are serious fractures and delays in diagnosis or misdiagnosis can have adverse outcomes for healing and potentially for long term use of the wrist.



  • Sports.
  • Fall from bike.
  • Motor Vehicle Accident.
  • Work injury.

Signs and symptoms

Diagnosis is based on symptoms, examination findings and scans:

  • Pain in the thumb side of the wrist. Wrist pain that does not go away after 2-3 may indicate a scaphoid fracture and medical attention should be sought.
  • Bruising.
  • Swelling.
  • Clicking.
  • Stiffness of wrist movement.



These should be used as first line but may sometimes miss the fracture.


CT Scan can show subtle fractures and reveal the amount of displacement (how much separation) there is between the fracture fragments.


This is sometimes used if there is concern about the blood supply of the bone especially in delayed presentation or fractures that are slow to heal.

Non-surgical treatment

Fractures with no separation of bone fragments can usually heal well without the need for surgery. The treatment for these patients includes:


A cast is used to keep the wrist still to allow the fracture to heal and settle the pain down. It is usually worn for 6-8 weeks.

Pain Killers / Anti-inflammatory Medications

These assist with pain only.


This will help with pain and swelling in first 2-3 days.

Follow up visits / x-rays

The bone fragments can move until the fracture heals. Follow up x-rays and visits are required to ensure that the fracture is healing well.


Physiotherapy may be required in some cases to return the wrist to normal strength and movement after fracture has healed.

Recovery and return to sport

Arm is kept in cast for a minimum of 6-8 weeks.

It may take 3-4 months before achieving normal strength and movement in affected wrist.

Risks of Non-surgical treatment

  • Non-union (Failure of healing). Fractures which are displaced, or which are closer to the wrist joint have a high rate of non-union.
  • Avascular necrosis (Loss of blood supply to the bone). Fractures which are closer to the wrist joint have a high rate of avascular necrosis.
  • Wrist Arthritis.
  • Weakness.


Scaphoid Fracture Fixation