What does it feel like?
Many patients describe a pain or an ache in the wrist, located as shown in the photograph.
What is it?
It is a fracture or break through a bone in the wrist called the scaphoid bone.
What causes it?
Scaphoid fractures often result from trauma or a fall onto the outstretched hand. These fall into three broad anatomic zones of fracture: the distal pole (the third of the bone closest towards the thumb), the waist (the middle third) and the proximal pole (the third of the bone farthest from the thumb and closest to the forearm). These are particularly relevant as the blood supply to the scaphoid is more tenuous in the proximal pole compared to the distal pole. As blood supply is a strong determinant of healing potential, the location of a scaphoid fracture is important.
What are my treatment options?
This depends on several factors, which include the location of the fracture in the scaphoid bone, the morphology of the fracture (comminution or number of pieces, and displacement or where the pieces lie relative to each other, and angulation or the change in angle of the bone). Scaphoid fractures should be appropriately assessed and treated promptly as delay in diagnosis and treatment affects outcome.
Sometimes scaphoid fractures can be subtle and not easily detected on Xray in the first couple of weeks. This is why part of the work-up of this injury may include radiological assessments like repeat XRays, CT scans and MRI scans. If there is any suspicion, you should arrange to get referred to see a hand surgeon.
The various treatment options depend on the fracture, but range from non-operative management in a cast to operative management, which should be undertaken by an appropriately qualified surgeon