Scaphoid Fracture

The scaphoid is a bone in the wrist joint which is the most fractured of all wrist bones in young people. It is nevertheless very strong, and takes a major impact to break.

Symptoms

Occurring within a joint, the severity of the fracture is often hidden from the sufferer, to whom it may feel like a relatively minor sprain. There is usually tenderness in the affected area. Pain varies from case to case, and the only other prominent symptom is usually inflammation which might disappear within days. The pain may be localised to the area below the thumb where the hand meets the wrist. The wrist is unlikely to appear 'broken', and this can make diagnosis difficult as many people initially overlook the injury, categorising it as a pulled muscle.

Causes

A significant fall can lead to a scaphoid fracture, with the sufferer landing on their hand and causing hyperextension of the wrist. Horse riders and cyclists are among the athletes at risk from such accidents. The fall can also be from a standing height as it is the impact which does the damage. Footballers and basketball players have been known to break their scaphoid, as have players of most contact sports. Hyperextension causing a fracture can also be provoked by incorrectly carrying a heavy object.

Possible Complications

Treatment is most successful if the patient is diagnosed within the first month. Due to the deceptive nature of the symptoms this often does not occur. If the initial medical treatment fails, or if the injury remains untreated because it has not been diagnosed, the loose chunks of bone in the wrist can eventually provoke wrist-specific traumatic arthritis. This worsens the pain and rigidity in the wrist, and can ultimately result in a joint unusable for many everyday activities. It is a serious condition but develops at different speeds in different people and can be avoided with swift treatment of the fracture.

Medical Treatment

If you suspect a fracture, consult a medical professional. They will perform a physical exam and are likely to use an x-ray or a bone scan to make a diagnosis. Occasionally a scaphoid fracture does not appear on an x-ray until some time later. The treatment required will depend on the severity and location of the fracture and how it has affected the associated ligaments. A doctor will talk you through the relevant options, which may involve surgery or a cast. This varies because certain sections of the bone are more receptive to casts than others, and fractures that leave the wrist particularly unstable should be treated with immediate surgery to avoid complications like prolonged pain or arthritis. Ask the doctor questions if you are unsure about treatment.

Returning to Activity

After successful treatment you should still refrain from sports or other activities with a contact component until the bone fully recovers. Also reduce your risk of falling wherever possible. Speak to your doctor for exact figures, but the time away from contact sports can often range between 2 and 3 months.

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