Scaphoid Fracture

Ice massages for 10 to 15 minutes, three to four times a day can help to reduce the pain and swelling of this type of fracture, which involves a break of the small bone near the thumb.

The wrist is comprised of eight closely packed small bones. A scaphoid fracture is a partial or complete break of the boat-shaped scaphoid bone located near the thumb. It is the most commonly fractured wrist bone, and because the scaphoid bone has a poor blood supply, it tends to heal slowly. That's why treatment of a scaphoid fracture can be frustrating for both physician and patient. This fracture is also known as a navicular fracture.

Causes
Scaphoid fractures are caused by a strong force exerted on the wrist or hand. They are frequently the result of a fall on an outstretched hand, a blow to the wrist or a car accident.

Symptoms
You will have pain and swelling on the thumb side of the wrist. Thumb and wrist movement may be limited and uncomfortable.

Diagnosis
Your doctor will examine your wrist and discuss the history of the injury with you. An X-ray will be needed to identify the location and extent of the break. Sometimes scaphoid fractures do not show up on regular X-ray and more sophisticated X-ray studies may be required.

Treatment
Your doctor will probably recommend a period of rest to limit wrist and hand movement. A cast may be needed to immobilize the wrist for nine to 12 weeks, depending on the extent of the fracture. Nonsteroidal anti-inflammatory medications can help reduce pain and swelling.

If the break is severe or if the bone fails to heal, surgery may be required to stabilize the fracture with some type of internal fixation device such as a screw. If there is any evidence of the bone failing to heal, a bone graft may also be necessary.

After the cast is removed, ice massages for 10 to 15 minutes, three to four times a day will help control pain and swelling. Your doctor will advise you when to begin gentle exercises to stretch the soft tissues. You may also be referred for hand therapy to guide your rehabilitation.

Complications
Complications depend on a number of factors such as your age, overall health, extent of the injury and how well you follow your doctor's instructions. Some problems that may arise include:

• Malunion (a bone that heals at the wrong angle)
• Nonunion (fracture in the bone which is not healed)
• Joint stiffness
• Loss of feeling due to nerve injury
• Osteoarthritis. A scaphoid fracture that fails to properly unite is the most common cause of severe wrist arthritis later in life. That's why a solid and satisfactory healing of the fractured scaphoid bone is so important.