Scaphoid fractures are breaks in the scaphoid bone, which is located where your wrist bends below the thumb.
Some scaphoid bone fractures require surgery to prevent arthritis and other long-term problems. So, if you think you might have a scaphoid fracture, you should seek care right away.
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Doctors define a scaphoid fracture as a break in the scaphoid bone of the wrist. This bone sits at the base of your thumb.
Despite its small size, a scaphoid fracture is serious. The low blood supply to this bone makes long-term pain, stiffness, and weakness more likely.
But, early treatment and follow-up care can prevent these problems from happening.
About 10% of breaks in the hand are scaphoid fractures. Around 60% to 70% of all breaks in the wrist bones (carpal bones) occur in the scaphoid bone.
Your doctor may refer to a scaphoid fracture as:
Because blood flows into the scaphoid bone from the thumb, proximal breaks are more serious. That part of the bone is more likely to lose blood supply.
All scaphoid fractures can be:
Scaphoid fractures often happen when people fall on an outstretched hand. Contact sports and car accidents can also cause scaphoid fractures.
Scaphoid fractures are more common in men, and adults. They can lead to long-term problems if not properly treated.
Scaphoid fracture risk factors include:
If not properly treated, scaphoid fractures can lead to:
Studies show that wrist guards can prevent scaphoid fractures.
You should wear wrist guards during activities where you have a high risk of falling on your wrist, such as skating, skateboarding, snowboarding, and rollerblading. If you're a beginner especially — don't skip wearing wrist guards.
Symptoms of a scaphoid bone fracture may not show up right away. But within days of injury, you may notice:
See your doctor right away if you have any scaphoid fracture symptoms after an injury. Pain in the wrist may be mild at first, which is why some people may not think they need to see a doctor. But, there's a high risk of the bone not healing without surgery if you delay treatment by several weeks.
Orthopaedic doctors and other providers can diagnose scaphoid fractures through a physical exam and imaging.
Your doctor will want to know how your injury happened, and about your symptoms. They'll ask you to move your wrist to assess stiffness and whether certain movements worsen pain. They'll also press on the area below the thumb to see if it's tender.
If your doctor thinks you have a wrist fracture, they'll order imaging tests, such as:
Sometimes, scaphoid fractures don't show up on an x-ray right away. If the x-ray doesn't show a fracture, your doctor may order a CT scan or MRI, as these tests are more accurate. Or, they may suggest you get another x-ray after a week or two.
Treatment for a scaphoid fracture depends on:
Most people need to wear a cast or splint for 6 weeks to 6 months to heal a scaphoid fracture.
The doctor will do an x-ray to ensure the bone has fused together before taking off the cast.
If your scaphoid fracture requires surgery, the surgeon will put the scaphoid bone together using screws, pins, or wire. You'll get general anesthesia, so you'll be asleep and won't feel pain during the surgery.
After surgery, you'll wear a cast or splint for at least 6 weeks, to speed healing.
Some proximal or displaced fractures may need a bone graft. Your surgeon will remove broken fragments of the scaphoid bone and then attach a small piece of bone taken from elsewhere in your body.
All scaphoid fractures require physical therapy. Your doctor, nurse, or physical therapist will teach you exercises that will gradually improve your wrist's strength and flexibility.
Most scaphoid fractures heal fully, especially with early treatment.
Scaphoid fractures that don't fuse with a cast or splint may need surgery. If you continue to have pain or weakness after scaphoid fracture treatment, see your doctor.
