Many people suffer what they think are fairly minor injuries, only to learn that they are actually much more significant. A “sprained wrist” that turns out to be a scaphoid fracture is a good example. In this Ask Dr. Geier video, I discuss the challenge if a scaphoid fracture didn’t heal.
Apparently I broke my scaphoid months ago and the doctor just now caught it because I was having a hand xray on a finger. I’ve never had any pain in my wrist or scaphoid area, none at all. They have me in a cast, but my take on it is, if I didn’t even know it was broken, why bother? There’s no pain and no swelling at all, and I wouldn’t have even known had I not had an xray for something unrelated. What is the risk, with no pain and having not even known I broke it, of taking the cast off and going on with life?
The scaphoid is the bone located at the base of the wrist on the side of the thumb. You can injure it by falling and landing on your hand. Often a patient thinks that they just sprained the wrist because there is no obvious deformity. X-rays, though, can show the fracture.
One major challenge with scaphoid fractures is getting them to heal properly. The blood supply to this bone is tenuous, so even nondisplaced fractures can fail to heal. Displaced scaphoid fractures almost always require surgery to line up the fracture and compress it with a screw. Hand surgeons often operate on some nondisplaced fractures in athletes. If nonoperative treatment is possible, the surgeon will likely still treat the patient by placing him in a long-arm cast.
Risk if a scaphoid fracture didn’t heal
If the fracture doesn’t heal properly, the bone can collapse, and the patient can develop degenerative changes in the wrist. If a scaphoid nonunion is seen on x-rays, the surgeon might fix the fracture surgically and add bone graft to help the bone heal. The key is doing what needs to be done to get the fracture to heal.
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