Broken scaphoid skin#

The doctor will examine several other bony prominences about the wrist and ask the patient to gently move the wrist and thumb through a range of motion. Physical examination: Tenderness in the anatomical snuffbox (the hollow between the tendons on the thumb side of the wrist) is the characteristic sign of a scaphoid fracture, though it is very nonspecific. Unlike the more common fracture of the radius, there is usually no visible deformity with a scaphoid fracture. Symptoms: Bruising or swelling of the wrist following a fall is suggestive of a serious wrist injury, particularly when associated with loss of motion of the thumb or wrist, or pain with hand gripping or lifting.

While a comprehensive physical exam is always performed on an injured patient, the imaging of the potential fracture is dependent on the type and timing of injury and the particular physical exam findings. Detection and diagnosisĪ physician can use several methods to determine a possible fracture of the scaphoid. Wolfe stresses that it is imperative that a scaphoid fracture be detected and treated as soon as possible. A fracture through the waist or proximal third of the bone (closest to the forearm) can disrupt the dorsal blood vessel and isolate the proximal fragment (closest to the forearm), preventing its nutrition and, ultimately, its healing. Since bones require a steady flow of blood to ensure proper healing, the scaphoid is uniquely vulnerable. They begin to develop shear forces and high stresses, and that leads to cartilage loss and, eventually, arthritis.Ĭompounding the issue is the tenuous blood supply to the scaphoid, which is comprised of a dominant vessel which enters the bone at its waist (midsection) along the dorsal (back side) ridge. Since the scaphoid provides cohesiveness and functional coordination to the two rows of carpal bones in the wrist, disruption of the scaphoid allows the two sets of bones to act in an uncoordinated manner. Wrist bones are so small, complex, and intricately related that they will rotate out of position, conduct forces abnormally, and begin to cause degenerative arthritis (osteoarthritis) if the scaphoid does not heal in a timely fashion. This color-coded diagram maps each of the 8 carpal bones, with the scaphoid in red. It is a crucial component of the wrist mechanism and coordinates the motion and position of all of the other wrist bones. The scaphoid (or carpal navicular) resides between the thumb and the bones of the forearm, and it resembles a large cashew nut. Wolfe notes that extra vigilance should be paid to every wrist injury, since the fleeting symptoms of a scaphoid fracture – in addition to its complicated shape and precarious blood supply – can lead to a failure of the two fractured bone ends to unite (also called a nonunion). Frequently, the injury occurs in sporting events such as skiing or snowboarding, although it can also occur as a result of a motor vehicle accident or similar traumatic force on the hand and wrist.ĭr. Unlike most other broken bones, the area around the scaphoid may not be noticeably swollen or intensely painful.Īccording to HSS hand specialist Scott Wolfe, MD, “because of the scaphoid fracture’s relatively innocuous symptoms, it may be mistaken for a sprain and remain undiagnosed for months or years, leading to long-term consequences of painful arthritis.”Ī scaphoid fracture is usually caused by a fall on the outstretched hand, and it occurs most often in young, active patients. This is due in large part to the subtlety of its symptoms.

The future of scaphoid fracture treatmentĪ fracture of the scaphoid, though a relatively frequent wrist injury, is often ignored, overlooked, or mistakenly attributed to a wrist sprain.Diagnosis and treatment of scaphoid nonunion.Do nonsteroidal anti-inflammatory drugs affect bone healing? A critical analysis.

Broken scaphoid skin#

National Institute for Arthritis and Musculoskeletal and Skin Diseases. Current Reviews in Musculoskeletal Medicine. American Academy of Orthopaedic Surgeons. Overview of finger, hand, and wrist fractures. American Society for Surgery of the Hand.