Scaphoid fracture is a fracture of one of the eight small bones that form the carpal bones of your wrist called the scaphoid. This bone connects the proximal row to the distal row, or, in plain English, the row closer to your forearm to the row closer to your hand. Since it is located in such a delicate and important place, a scaphoid is easily broken due to the connection it makes to two different body parts, and injuries of the scaphoid are common. Do not let the odd name scare you, as we have prepared the list of scaphoid fracture symptoms which will ease even the most upset of minds.
But first, let’s see what can actually cause the fracture to happen at this particular part of the body.
First of all, a scaphoid bone is the most common of the carpal bones to break, or fracture if you will. Why? Because it is the largest bone out of all the carpal bones, and it is located on the thumb side of your wrist. Additionally, it connects the two aforementioned rows of carpal bones together and stabilizes them.
A scaphoid fracture mostly occurs when you fall on your outstretched hand, meaning when you fall onto your flat palm and your wrist kind of bends backwards upon the fall. Unfortunately, this is very hard to avoid, as this position is the natural one most people take when they fall, to protect themselves from the impact.
In other cases, a fracture can happen when you receive a direct blow to your palm, or, alternatively, when your scaphoid bone is under repetitive stress, for example if you are a gymnast or a shot putter, discobolus, or a javelin thrower. Generally speaking, the scaphoid fracture is the most common fracture of the bones in the carpal area.
List of Symptoms of a Scaphoid Fracture
Snuff box tenderness. Many patients who have a fractured scaphoid will report the tenderness of a snuff box. The anatomical snuff box is the deepening in a triangular shape of the carpal area of the hand. When you fall onto your outstretched hand, this area is the one who takes all the brunt of the force. This is why the tenderness of this area is one of the sure symptoms of the fracture of a scaphoid bone.
Pain. Pain with no swelling or bruising is also one of the symptoms, and usually is noticed a few days after the fall or injury. Since there is no visible deformity in this area, and since most people do not experience any difficulties with hand motions, a scaphoid fracture can be easily mistaken for a sprain of the wrist. However, you should be wary of these symptoms, as delaying the treatment can lead to a number of issues, and you should go to your doctor as soon as you notice this strange pain as he or she will assess the situation and provide you with the proper treatment.
Swelling. We know that scaphoid fractures can happen with no swelling, however, in some cases, the swelling around the wrist can occur. This happens because the blood vessels close to your fractured scaphoid bone fill the wrist joint, resulting in the swelling of a joint capsule which is a watertight sac that surrounds the joint itself.
Movement issues. If you notice that you have trouble moving your thumb or your wrist, it is highly likely that you have fractured your scaphoid. However, this symptom, as well as all the others, may not occur directly after the injury, but instead lay dormant and appear after a few days, weeks, or even longer.
Numbness and tingling. Sometimes, you may experience the numbness or a tingling sensation in your thumb or fingers. If you do notice this, go to your doctor immediately as this can be a sign of a serious issue with your blood vessels.
White, blue, and cold. If your thumb or fingers become cold, and either white or blue in color, do not hesitate and seek immediate medical care. This could be a sign of arterial embolism or severe arterial spasm. Arterial embolism is a sudden interruption of a blood supply to a specific body part that occurs due to a clot from another part of the body. If this is the case, a trauma due to the fall could have moved the clot which ended up in the hand area, so make sure to seek immediate medical help to prevent the loss of fingers or thumb.
The Importance of Early Diagnosis
Since scaphoid symptoms can be sneaky and pretty covert, it is sometimes difficult for us to assess the situation properly, and in result, we avoid seeking professional medical opinions. However, it is important to remember that the scaphoid bone generally has a poor blood supply, which means that it cannot heal well on its own, especially with the continuous stress that it endures every day.
Furthermore, if it happens that your scaphoid bone is displaced when fractured, that is, that two or more pieces of the bone have moved from their original location and away from one another, the odds of spontaneous healing are even lower. If this happens and you do not receive proper medical treatment, the blood supply to this area may not be established again and the bone can degenerate and tissue necrosis can happen, and that is a very serious health issue that absolutely must be dealt with professionally.
Proper treatment of a fractured scaphoid varies on the severity of the injury. Non-displaced fractures can be treated with simple immobilization with a long or short arm cast, or a rigid splint. However, if a fracture does not heal after approximately four months, a surgery might be necessary in order to heal the bone. Sometimes, a doctor may recommend a bone stimulator which can help with the healing. This is a small device that delivers electromagnetic waves that stimulate the healing process and make it shorter.
Displaced fractures on the other hand, most commonly require a surgery in order to heal. Some surgeons opt for screw fixation, some for bone graft method, scaphoid debridement. Scaphoid debridement is a process in which a surgeon locates the old fracture line and debrides the scar tissue in order to create a fresh bone surface that can later heal again. Bone graft on the other hand is a process in which a surgeon takes bone tissue from another place on your wrist and inserts that particle into the fracture.