Scaphoid fractures

The scaphoid is one of the commonest bones to be fractured in the wrist. Scaphoid fractures can be problematic because they can be difficult to pick up on x-rays, and because the blood supply to the scaphoid runs back on itself, which means they don’t always heal as predictably as other bones do. It’s important that the scaphoid bone should heal because if it doesn’t it tends to set off a predictable pattern of arthritis in the wrist which can lead to future pain and stiffness. This often requires extensive surgery to try to improve the symptoms.

Some scaphoid fractures close to the wrist joint are treated routinely with surgery to improve the healing rates. Others can be treated in plaster, but with a follow up CT scan at 6 weeks to make sure they are healing. If they are not, then surgery can be recommended.

Surgery for scaphoid fractures is commonly done using a screw which applies compression across the fracture sites. On some occasions a plate and screws might be required. A plaster is applied for six weeks after the surgery, and then the patient is encouraged to move the wrist under the supervision of a hand therapist. The hand should be elevated for five days after surgery and the wound must be kept clean and dry for two weeks.