Your hands and wrists contain a lot of bones, and in the wrist alone are eight individual bones. Set in two rows, they are linked by one bone known as the scaphoid. Unfortunately, due to its position and the role that it plays in the hand and wrist, it is the most commonly fractured bone in the hand. Even worse is that a fracture of this bone is not always easy to diagnose, and some people are unaware of the severity of an injury to their hand for days or even weeks afterward.
This is particularly troublesome because the location of the bone already makes it challenging to heal. It is well known that the blood supply to the scaphoid is fragile even before any breaks may occur, and afterward it may be completely impaired. This can make it almost impossible for it to heal, and when this happens it is known as a non-union injury.
And though it is a tiny bone, the scaphoid non-union can lead to diminished or lost movement of the wrist and even to arthritis.
Diagnosis and Treatment
A fractured scaphoid is often due to a fall, and though it might hurt initially, it often seems to get better quickly, and this is why diagnosis can be tricky. As the American Association of Orthopedic Surgeons explains, “A scaphoid fracture is usually caused by a fall on an outstretched hand, with the weight landing on the palm.” (AAOS.org, 2015)
Thus, you may think you have merely sprained the wrist, and once the discomfort ends you may forget the incident, even though movement of the wrist now seems limited. This is why no falls of this kind, and no hard blows to the wrist can be ignored or overlooked.
A visit to the hand doctor is the only way to determine if a fracture has occurred, and if it is of the difficult non-union variety. In fact, you may find yourself getting in touch with them soon afterward because the non-union fractures so often follow a very common pattern. The wrist begins to lose range of motion, stiffness sets in, and even arthritis symptoms may start to appear because of the persistent inflammation to the tissue.
If your case is not advanced, you may be able to have the most conservative treatments such as therapy or surgery to align the bones and trigger healing. However, you may also need the use of surgical pin or bone grafts if the absence of blood has caused bone death.
In advanced cases, surgery is still an option but it will be to help manage pain and preserve what movement remains. It is always a case of “the sooner the better” in such cases. So, if you have recently taken a fall that may have harmed the scaphoid bone in your wrist, or you feel that an old injury is causing problems, dont hesitate to phone your hand doctor for a thorough exam and discussion of your options.
AAOS.org. Scaphoid Fracture of the Wrist. 2015. http://orthoinfo.aaos.org/topic.cfm?topic=A00012