Scaphoid Fracture
A scaphoid fracture is a break in one of the small bones in the wrist on the thumb side. It most commonly occurs after a fall onto an outstretched hand. Symptoms may be mild at first and the injury can sometimes be mistaken for a wrist sprain. Some scaphoid fractures can be slow to heal, so assessment and follow-up are important.
Cause of Injury
- Fall onto an outstretched hand
- Sporting injuries, particularly contact or high-impact sports
- Motor vehicle or bicycle accidents
Symptoms
Symptoms may vary and are not always severe at first. They can include:
- Pain or tenderness on the thumb side of the wrist
- Pain when pressing over the scaphoid (“snuffbox”) area
- Swelling around the wrist
- Pain with gripping or wrist movement
- Reduced wrist strength or movement
- Pain that does not settle over time
Some patients can still move their wrist, which may delay diagnosis.
Type of Fracture
Scaphoid fractures are described by:
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Location
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Distal pole (near the thumb)
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Waist (middle of the bone – most common)
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Proximal pole (near the forearm)
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Stability
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Non-displaced (bone remains aligned)
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Displaced or unstable (bone position has shifted)
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The fracture type helps guide treatment and expected recovery time.
Assessment and Investigations
Assessment usually includes:
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Clinical examination
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Wrist X-rays
Some scaphoid fractures are not visible on early X-rays. If pain and tenderness persist, further imaging may be required, such as:
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Repeat X-rays
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MRI scan
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CT scan
These tests help confirm the diagnosis and monitor healing.
Management
Management depends on the fracture type, location, and individual factors.
Non-surgical management
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Commonly used for non-displaced fractures
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Wrist immobilised in a cast or splint
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The thumb may be included
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Immobilisation often continues for 6–12 weeks, depending on healing
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Follow-up appointments and imaging are required
Surgical management
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May be considered for displaced, unstable, or higher-risk fractures
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May also be considered if healing is delayed
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Usually involves fixation with a small screw
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A period of immobilisation is still required after surgery
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Follow-up is required to monitor healing
Healing and Recovery
- Bone healing often takes 6–12 weeks, but may take longer
- Fractures closer to the forearm may heal more slowly
- Stiffness and weakness are common after immobilisation or surgery
- Movement and strength usually improve gradually
- Hand therapy or physiotherapy may be recommended
Smoking and delayed treatment may affect bone healing.
Use of the Hand and Weight-Bearing
- Do not lift, push, pull, or weight-bear through the injured wrist while in a cast or splint
- Light use of the fingers for daily activities is usually allowed
- Activities are increased gradually once healing is confirmed
- Heavy lifting, gym work, and contact sports should only be resumed when advised by your treating team
Cast Care
Proper cast care helps reduce the risk of complications while your fracture is healing.
Looking after your cast
- Keep your cast clean and dry at all times
- Cover the cast with a waterproof protector when showering
- Do not cut, trim, or modify the cast
- Do not insert objects inside the cast to scratch the skin
- Avoid using powders, creams, or sprays inside the cast
Swelling and comfort
- Elevate your hand above heart level when resting, especially in the first few days
- Gently move your fingers regularly to help reduce swelling and stiffness
- Use simple pain relief as advised by your treating team
Using your hand
- Use your fingers for light activities only
- Do not lift, push, pull, or weight-bear through the cast unless advised
- Avoid activities that cause pain or place strain on the wrist
Check your cast daily
Seek medical review if:
- The cast feels too tight or painful
- You notice increasing swelling, numbness, or tingling in the fingers
- Your fingers become pale, blue, or cold
- The cast becomes loose, cracked, damaged, or wet
- There is an unpleasant smell or discharge from inside the cast
If your cast gets wet
- Do not use heat or a hairdryer to dry it
- Contact your fracture clinic for advice, as a wet cast may need to be changed
Possible Complications
Some scaphoid fractures may take longer to heal. Possible complications include:
- Delayed healing or non-union
- Ongoing wrist pain or stiffness
- Reduced grip strength
- Development of wrist arthritis over time
Regular follow-up helps reduce these risks.
When to Seek Urgent Review
Seek medical advice urgently if you have:
- Increasing pain not controlled with simple pain relief
- Increasing swelling in the hand or wrist
- Numbness, tingling, or loss of feeling in the fingers
- Fingers becoming pale, blue, or cold
- Increasing tightness or pain in the cast or splint
- A cast or splint that becomes loose, damaged, or wet
- Signs of infection after surgery (redness, warmth, discharge, fever)
How long will my scaphoid fracture take to heal?
Healing commonly takes 6–12 weeks, but some fractures take longer depending on their location and stability.
When can I return to sport or exercise?
Return to sport depends on fracture healing and activity type. High-impact or contact activities usually require clearance from your treating team.
Can this injury be covered by insurance?
Work-related injuries may be covered by workers’ compensation. Injuries from motor vehicle accidents may be covered by CTP insurance. Please inform clinic staff if applicable.
When can I return to work?
This depends on your job requirements. Light duties may be possible earlier. Manual work usually requires confirmed healing.
Will I need physiotherapy?
Some patients are referred to hand therapy or physiotherapy to help regain movement and strength.
What can I do to support recovery?
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Follow your treatment plan
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Attend all follow-up appointments
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Avoid heavy or painful wrist use
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Avoid smoking
