The scaphoid is a small bone in the wrist at the base of the thumb that is commonly fractured (broken) after a fall.
It is at risk when patients have a fall onto an outstretched hand. The scaphoid is at risk when a fall is sustained on an outstretched hand.
A scaphoid fracture can cause significant loss of function if missed because its anatomy means it may not receive the blood supply it needs.
Symptoms of scaphoid fractures
Diagnosis of scaphoid fractures
Scaphoid fractures are diagnosed with a clinical history, physical examination and X-rays. As this is an injury that can be missed it may require repeat imaging and careful assessment to find the break. If the scaphoid bone is not broken further tests may be required to assess the ligaments.
Treatment of scaphoid fractures
In some cases a plaster cast may be all that is needed. With more serious breaks an operation may be required. This is usually when the fracture is displaced. Typically operative fixation involves metal screws, wires or both to surgically stabilise the fracture. This type of operation is usually done as a day case through a small skin incision using a minimally invasive technique.
Scapholunate ligament reconstruction
An injury to the scapholunate ligament can range from a minor sprain that can be repaired using arthroscopy (key-hole surgery) as a day case procedure, to complete ligament disruption that needs reconstruction using one of a patient’s own tendons.
After the surgery a plaster cast will be applied to allow the ligament to heal for 4-6 weeks. This will be followed by a removable splint and intensive hand therapy.
Surrey Orthopaedic Clinic
Hand & Wrist Fracture Specialists:
Mr Nick Masucci