A scaphoid (navicular) fracture is a break in one of the small bones of the wrist. This type of fracture occurs most often after a fall onto an outstretched hand. The scaphoid is one of the carpal bones, the collection of bones that makes up the wrist. Scaphoid fractures are the most common carpal bone fracture comprising about 15 percent of all reported wrist injuries – typically due to a fall but it is also seen in auto accidents and as a result of a sports injury.

How it happens

Scaphoid fractures happen when the arms are outstretched in an attempt to stop a fall or collision, with the weight of the impact landing an outstretched hand and palm. The end of the larger forearm bone (the radius) can also be injured or broken in this type of event. It typically takes about three months to heal from a scaphoid fracture, and some people require surgery when the break is severe. Also, because the scaphoid bone naturally receives less circulation, complications with the healing process are common with this condition.

Structures of the wrist

The wrist is formed by the two bones of the forearm—the radius and the ulna—and eight small carpal bones. The carpal bones are arranged in two rows at the base of the hand. There are four bones in each row. The scaphoid bone is one of the carpal bones located on the thumb side of the wrist, just above the radius. The bone is important for both motion and stability in the wrist joint. The word “scaphoid” comes from the Greek term for “boat.” The scaphoid bone resembles a boat with its relatively long, curved shape.

There are 2 basic levels of scaphoid fractures:

  • Non-displaced where the bone fragments line up correctly.
  • Displaced where the bone fragments have moved out of their normal position leaving gaps between the pieces of bone or bone fragments may overlap each other. Displaced fractures are much more likely to require surgery to repair.

Scaphoid fractures usually cause pain and swelling in the base of the thumb and on the thumb side of the wrist. The pain can become severe when the thumb or wrist is moved, or when trying to pinch or grasp something. Unless the injury was accompanied by a deformity, it might not be obvious that the scaphoid bone has been broken. When the pain is not severe a broken bone or scaphoid fracture may be mistaken for a wrist sprain. Wrist pain that does not go away within a day of injury may well be a sign of a fracture, which may need to be treated by a doctor. So, bear in mind that prompt treatment of a scaphoid fracture will help avoid potential complications.

Information for this article provided by AAOS & OrthoInfo.

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