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FAQ: Is a scaphoid fracture serious?

A scaphoid fracture can lead to wrist osteoarthritis, especially if the fracture is untreated and does not heal correctly. This is called “nonunion.” Severe cases of this kind of osteoarthritis can lead to an incorrect alignment of wrist bones in what is called scaphoid nonunion advanced collapse (SNAC).
Scaphoid fractures usually cause pain and swelling in the anatomic snuffbox and on the thumb side of the wrist. The pain may be severe when you move your thumb or wrist, or when you try to pinch or grasp something. With some scaphoid fractures,the pain is not severeand may be mistaken for a wrist sprain.

How bad is a scaphoid fracture?

Scaphoid fractures usually cause pain and swelling in the anatomic snuffbox and on the thumb side of the wrist. The pain may be severe when you move your thumb or wrist, or when you try to pinch or grasp something. Unless your wrist is deformed, it might not be obvious that your scaphoid bone is broken.

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How long does it take for a scaphoid fracture to heal?

Healing: Average time to union of the scaphoid is twelve weeks. Depending on the rigidity of the bone fixation and need for bone graft, the wrist may be casted for four, six, eight or 12 weeks.

Do all scaphoid fractures need surgery?

Yes. If you receive proper treatment and restrict activity with your hand, a scaphoid fracture may heal without surgery. Your doctor will likely recommend casting if it appears that the bones may heal on their own. The cast immobilizes your wrist, so the pieces of bone to fuse back together.

Why are scaphoid fractures so problematic?

Because of the tenuous blood supply, a scaphoid fracture can sever this blood flow and stop the delivery of necessary oxygen and nutrients to the bone cells. When this occurs, healing can be slow, and the scaphoid fracture may not heal at all.

Can I work with a scaphoid fracture?

Your fracture should unite over a 6-8 week period but it can often be 3 months before you can return to heavy manual work. The fracture can take even longer to heal and patience may be required.

Can you move your hand with a scaphoid fracture?

Most people with a scaphoid fracture (which is the same as a broken wrist) will have pain and/or swelling along the thumb side of the wrist within days following a fall. Because there is no visible deformity and no difficulty with motion, many people with this injury assume that it is a wrist sprain.

What happens if you don’t treat a scaphoid fracture?

If a Scaphoid fracture does not heal, it is called a Scaphoid Fracture Non-union. If left untreated, the part of the Scaphoid that interacts with the Radius may die, which can lead to painful arthritis in the wrist, developing months to years after the initial injury.

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How long does scaphoid fracture hurt?

Your wrist will probably feel stiff for about a month or two after the cast is off. You might continue to have a dull ache or stiffness for about two years. Some people develop carpal tunnel syndrome after having a Colles’ wrist fracture.

What is the best view to witness a scaphoid fracture?

Standard views vary among institutions, but most use a minimum of 3 views: PA, true lateral, and semipronated oblique with, in many instances, ulnar deviation. The patient with a scaphoid fracture often holds the wrist in radial deviation, thereby shortening the scaphoid and limiting its evaluation.

What type of cast is used for a scaphoid fracture?

Plaster. Immobilize the wrist in a well -padded, below-elbow cast, with the wrist slightly extended, and the proximal phalanx of the thumb included in a position of slight opposition (“scaphoid cast”). An alternative is a radius plaster, the so-called “Colles” cast.

Can the scaphoid bone be removed?

Surgery can also be done in stages. Removal of the damaged scaphoid and a four corner-fusion allow for some wrist motion to be saved. Alternately, the affected row of carpal (wrist) bones can be removed completely. Further treatment failure may lead to total fusion of the wrist joint.

What happens if your scaphoid bone dies?

Avascular necrosis occurs when part of the scaphoid bone dies because of the loss of blood flow. This can eventually result in fragmentation and the collapse of the bone. Its presence also makes repair of the scaphoid much more difficult.

Does the screw stay in for scaphoid?

Scaphoid fractures are often fixated using titanium Herbert screws, which generally remain in the body.

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When does a scaphoid fracture need surgery?

Surgical treatment is indicated for non-displaced scaphoid fractures which have not healed after 6 weeks of splinting. It is also necessary for unstable scaphoid fractures and displaced scaphoid fractures. Screws are most often used to realign the scaphoid fragments via open reduction and internal fixation.

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