The scaphoid bone forms part of the wrist joint. It’s a small, boat-shaped bone located near the thumb which puts it at higher risk of damage.
Scaphoid fractures of the wrist can occur either near the forearm or near the thumb. However, they often go undetected making them one of the most common reasons for law suits in the UK.
What causes scaphoid fractures?
Scaphoid fractures typically occur when someone has fallen over and their outstretched hand has meant their palm took all their weight. Other than falls, they’re often the result of motoring accidents or playing sport.
With scaphoid fractures there is usually a fair amount of pain and swelling around the base of the thumb and forearm. As the bone is so small there isn’t usually any deformity so breaks are often mistaken for sprains. The pain also tends to lessen over a few days, so often the patient doesn’t even know it’s broken.
Diagnosing a scaphoid fracture
An x-ray will be needed to diagnose a scaphoid fracture, however non-displaced fractures typically don’t show up during the first week. This is why it’s so important to assess the tenderness at the site, with a second x-ray potentially required a few weeks later.
Patients should also be advised to use a splint and avoid heavy lifting. In some cases an MRI or CT scan may be required.
What treatment path should be taken depends on where the scaphoid fracture actually is – i.e near the forearm or near the thumb.
Non-surgical treatment: If the scaphoid fracture is not displaced then non-surgical treatment may be offered. This will involve immobilising the forearm as well as the hand and/or thumb in a cast. If the fracture is near the forearm, the elbow may also need to be immobilised.
Healing time is usually from 6 to 10 weeks. Fractures close to the thumb are often quicker to heal than those near the forearm due to blood supply.
Surgical treatment: Surgical treatment is an option if the fracture is displaced or is located near to the forearm. Surgery will involve an incision being made either in the back or front of the wrist. Screws and wires will then be inserted to hold the scaphoid bone in place as it heals. If the bone is broken in two or more pieces, a bone graft (typically extracted from the hip or forearm) may be required to aid healing.
Boost your confidence in identifying and treating scaphoid fractures effectively
Aimed specifically at nurses, paramedics and other allied health professionals, PDUK looks at multiple types of hand and wrist injuries in our courses:
Both courses are currently being offered online so are perfect if you’re looking to gain extra CPD hours remotely.
The Assessment and management of hand injuries online course focuses on adult patients and is perfect for those who regularly assess hand injuries in an acute setting. It’s a half-day course worth 4 and will next be held on the 3rd March 2021.
The Wrist and elbow minor injuries course is also a highly interactive, flexible programme for those who regularly deal with wrist and elbow injuries/ailments. It’s a half-day course worth 4 hours of CPD, and is due to be held on the 3rd March 2021 from 1pm to 4.30pm.
March is just around the corner and spaces fill up fast – sign up today!