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What You Should Know About Scaphoid Fractures

The scaphoid is one of the smaller bones that form a part of the wrist. It is located just under the thumb.

A scaphoid fracture occurs most commonly when you fall on your outstretched hand. Pain and swelling around the wrist are typical symptoms of a scaphoid fracture. However, because of the complex anatomy of the wrist, a break in the scaphoid bone can sometimes be difficult to identify on X-Rays. Sometimes, it does not even show up on an X-Ray. If a scaphoid fracture goes undetected or if treatment is delayed, it can result in permanent and irreversible damage to the wrist.

Anatomy Of The Wrist

Unlike most other joints that typically consist of two large bones connected at a joint, the wrist joint has an extremely complex structure. It is made up of a collection of eight separate small bones called carpal bones. Each of these small bones forms a joint with the bone next to it. All the small bones are connected to each other and to the ulna, radius and metacarpal bones by ligaments.

In addition to providing the strength for heavy gripping, the elaborate structure of the wrist joint also gives it a high degree of mobility, which gives our hands a full range motion.

Common Causes Of Scaphoid Fractures

The scaphoid bone is a small carpal bone located just under the thumb. When falling forwards to the ground, most of us instinctively put out our hands to break the fall. While this may protect the Scaphoid Fractureface, falling on your outstretched hand puts a lot of force on the scaphoid bone. This sudden, excessive stress can cause the scaphoid bone to either crack at some point midway along its length or it can separate completely into two individual pieces.

A direct blow to the palm of your hand can also cause the scaphoid bone to break. In very rare cases, such as in the case of gymnasts and shot putters, scaphoid injuries may result from repeated stress on the scaphoid bone.

When you have a fractured scaphoid bone, you will most likely remember the specific fall or injury that may have caused the fracture as it would not have been an insignificant incident.

Symptoms Of A Scaphoid Fracture

Pain around the wrist is the most common symptom of a scaphoid injury. The pain may or may not be accompanied by bruising and swelling around the wrist on the affected side. The exact symptoms and the severity of the symptoms will depend on the extent of the fracture.

Most people may suspect that they have a fracture if the pain and swelling are severe. However, they are more likely to assume that they have suffered a simple sprain if the pain and swelling are mild and they don’t seek medical attention till much later. It is quite common for the fracture to be diagnosed only much later when the incessant pain or restricted wrist movement forces them to make an appointment with their doctor.

A doctor will first ask you to get an X-Ray done to confirm that you have a scaphoid injury. If it is too soon after the accident and the X-Ray does not show any signs of fracture, your doctor may order an MRI scan (magnetic resonance imaging) or other imaging tests in order to get a definitive diagnosis.

Scaphoid Injury Treatment

There are two types of scaphoid fractures – displaced and non-displaced.

In a non-displaced fracture, there is no movement of the bone fragments. All the broken bone fragments would still be in the same position.

In a displaced fracture, the broken bone fragments would have moved out of position.

If the X-Ray confirms a non-displaced scaphoid fracture, it is usually treated by putting the arm in a cast that extends from a little beyond the wrist up to the elbow. The cast is typically made of fibreglass or some other synthetic material and is worn for about six to twelve weeks until the scaphoid bone heals. Sometimes, it may need to be worn a little longer than twelve weeks.

If the X-Ray confirms a displaced scaphoid fracture, surgery may be required to heal the injury. This is done by making a small cut in the skin and inserting a small screw or a special pin into the scaphoid bone to hold the bone fragments together in the correct position. Further X-Rays may need to be done to confirm that the fracture has healed.

Depending on the type of fracture you suffered and treatment you underwent, you may need to also go for physiotherapy or occupational therapy sessions for six to eight weeks after the surgical or non-surgical treatment. The first few sessions will focus on reducing the pain and swelling. Your physiotherapist or occupational therapist may also recommend a few exercises that have been proven to help stabilise and strengthen the tendons and muscles around the wrist joint.

If your fine motor control or hand dexterity are compromised because of the scaphoid injury, the physiotherapist may recommend a few special exercises to improve function in these areas. You will also be given tips on different ways to perform everyday tasks while avoiding extra strain on the wrist joint.

Complications With Scaphoid Injuries

A scaphoid fracture usually heals well if it is diagnosed correctly and treated early. Unfortunately, this is not an easy injury to diagnose. The complex anatomy of the wrist makes accurate diagnosis challenging and in many cases, the fracture remains undetected and can lead to further complications. Some people may also suffer from premature osteoarthritis as a result of the scaphoid injury.

An undetected, untreated scaphoid injury could eventually result in the movement of the wrist getting severely restricted. If a doctor fails to diagnose the scaphoid fracture and as a result the injury does not get the necessary treatment, it is tantamount to a medical negligence. According to the personal injury law in the UK, you may be entitled to file a claim for compensation for a scaphoid misdiagnosis due to medical negligence.

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  • Rob Jarvis

    I have a displaced scaphoid which was left undiagnosed for 8 weeks. I repeatedly told the GP that I thought my wrist was broken,l and presented to him that the flexibility of my wrist was severely limited with less than 30% movement, but he told me I must wait 8 weeks after the initial X-ray taken on the day of the injury showed no damage. The X-ray after waiting 8 weeks showed the scaphoid was out of position. I need to have an urgent operation which is booked for Thursday and is nearly 13 weeks after the initial injury. The prognosis is a lot bleaker I understand because the diagnosis is furthest down the line than should be expected with this injury. I have been and will be unable to perform duties at my own run plumbing and heating business for what will be in excess of 6 months. I am also unable to play golf or enjoy fishing with my son. 2 things that are very important to me. They have also told me that I will now suffer with pain in my wrist for the rest of my life. I am sure all of this would have been avoidable if I hadn’t have been told to contralto wait for a second X-ray.

    The injury occurred when I took my 2 dogs to the vet. I had them in the clinic at the same time. Myself and the vet were distracted by the smaller of my 2 dogs and the larger one fell from the vets table. I put my hand out to catch him and he caught my fingertips, bending my hand around and rupturing my scapholunate ligament. This is why I require surgery.

    • Hello Rob, I am sorry to hear of your situation, a displaced scaphoid can be quite a debilitating and restrictive injury, and certainly not an injury anybody would want when trying to run a plumbing and heating business.

      If you would like to speak with a solicitor about claiming compensation please call 0800 6524 881 or you can email as at claims@accidentclaimsadvice.org.uk. An initial consultation typically takes around 10 minutes and is free of charge.

      All the best.

      • Candance Scales

        What can I do if I am experiencing the same problem Rob described. I went to the ER twice and was seen by the same doctor each visit and upon my wrist being x-rayed was told there was no broken bones in my left wrist.
        I left both visits in pain and frustrated because I know my left wrist is broken since I just had the same injury to my scaphoid bone on my wrist.
        Even though I visited the same hospital , I was seen by a female doctor who educated me about this type of injury after the x-ray confirmed the scaphoid bone in my wrist was broken.
        I admit it does seems unusual to have this happen to my left wrist while still not completed healed from the injury on my right wrist, but it’s just the way it is.
        My question is : What , if anything , can I do, who can I contact about claiming compensation since I was told my left wrist is not broken when I know it is.
        But I live in the state of Texas in the united States of America.
        Please thank you!

        • Hi Candace,

          We are based in the UK so cannot really advise on what you can do if you’re in the USA. I should think there’s personal injury lawyers over there that will gladly advise you on what action you could take.

          All the best.

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