Everything You Need to Know About Scaphoid Fractures
A scaphoid fracture is a type of wrist injury that is often ignored. Sometimes, this condition is also misinterpreted as a wrist sprain. One of the reasons for this is that in most cases of scaphoid fractures, the injured area does not show any visible symptoms like swelling or bruising. Due to innocuous symptoms produced by scaphoid fractures, the condition may remain undiagnosed for months or years. If this occurs, it may lead to long-term complications like painful arthritis.
What is Scaphoid Fracture?
A scaphoid fracture is a condition where one of the carpal bones present in the wrist gets broken. There are eight carpal bones present in the wrist and one of them is the scaphoid which is present on the side of the thumb. Scaphoid fractures are common and they account for around 70 to 80% of all carpal bone fractures. This type of fracture can occur at any age while the chances of occurrence in adolescents and young adults are high. In the elderly, this condition is a bit uncommon because the occurrence of distal radial fracture is high when they fall on the wrist. The surgical treatment of such fractures is carried out with the application of Cannulated screws to hold broken bone fragments in their correct anatomy for proper healing.
Scaphoid fractures most commonly occur when someone falls onto an outstretched hand and the impact caused due to falling results in the fracture to the scaphoid bone. The degree of impact and position of the wrist will decide whether the fracture will be displaced or non-displaced. In case of a displaced fracture, the fractured bone fragments move out of their position. While the case is the opposite in non-displaced fracture, in this condition the broken bone fragments stay in their normal anatomical position.
Diagnosis of a scaphoid fracture is not easy because X-ray examination right after injury might not show any abnormality. This condition is most common if the fracture occurred is a non-displaced fracture. But the X-ray might show a fracture after the healing has started. So, the detection of scaphoid fracture may be delayed for months or even years.
The doctors also suggest an MRI scan to confirm whether there is a fracture or not. MRI examination will also eliminate the need for repeated X-ray examinations.
Based on the type of scaphoid fracture that occurred, the treatment is classified into two types:
- Cast Immobilization
- Surgical Stabilization
Application of a cast is the choice when the fracture is nondisplaced. Hence, immobilizing the fracture by casting is proven to be highly effective in the case of scaphoid fracture where the broken bone fragments do not leave their position. The cast is extended to the thumb to restrict the thumb’s mobility. After casting, the doctor will indicate continuous X-ray examination to check the progress. Generally, it takes around 10 to 12 weeks for a scaphoid fracture to heal.
Surgical stabilization is done in case of displaced scaphoid fracture where the fractured bone fragments leave their anatomical position. During surgical stabilization, the surgeon uses a Cannulated Compression System to realign and fix bone fragments in their normal position while allowing proper healing.
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A displaced scaphoid fracture has a high chance of developing nonunion, and when this occurs, surgery with bone grafting is the option to allow the bone to heal. These types of injuries can be complex and there is a chance of developing wrist arthritis later in life.