The often missed wrist injury
Ahh the dreaded scaphoid fracture! This is a nasty injury typically caused by a fall on an outstretched hand. They can be missed, so if you have persistent pain – get it checked out!
The scaphoid is a bone located in the wrist, just near your thumb. Check out the picture to get a better idea of it.
One of the biggest issues with scaphoid fractures is that they can be difficult to pick up initially as people generally assume that they just have a wrist sprain when an x-ray comes back clear. Confusing the situation further is that there isn’t usually any visible deformity, swelling or bruising. X-ray’s are notoriously unreliable for this type of fracture within the first couple of weeks.
The other tricky issue with scaphoid fractures is the poor blood supply to the area (the picture above gives you a better idea of how the blood supply works) and so there is a slower healing rate (delayed union) and a relatively high chance of the fracture not healing (non-union).
If you have a non-displaced or minimally displaced fracture of the distal area or waist area (see above), the main form of treatment is cast immobilisation for anywhere from 6-12 weeks. Traditionally this would involve immobilising your CMC joint (big knuckle) in your thumb. Research has shown that this is unnecessary and not required for your bone to heal.
“Immobilization of the thumb appears unnecessary for CT or magnetic resonance image–confirmed nondisplaced or minimally displaced fractures of the waist of the
scaphoid.”The Journal of Hand Surgery (2014)
As the scaphoid bone is in the first row of your wrist bones, only the joint above and below needs to be immobilised so a standard wrist short arm cast immobilisation will do the job.
Once you have done your stint in the cast, physiotherapy can be commenced to restore range of motion, strength and function back to that arm. Common treatment options include joint mobilisation techniques, soft tissue massage and theraputty and theraband strengthening exercises.
If you have a current scaphoid injury, reach out to us as we’d be more than happy to help!