Scaphoid fracture
| Scaphoid fracture | |
|---|---|
| Other names | Carpal scaphoid fracture, carpal navicular fracture[1] |
| An X-ray showing a fracture through the waist of the scaphoid | |
| Specialty | Hand surgery, emergency medicine |
| Symptoms | Pain at the base of the thumb, swelling[2] |
| Complications | Nonunion, avascular necrosis, arthritis[2][1] |
| Types | Proximal, medial, distal[2] |
| Causes | Fall on an outstretched hand[2] |
| Diagnostic method | Examination, X-rays, MRI, bone scan[2] |
| Differential diagnosis | Distal radius fracture, De Quervain's tenosynovitis, scapholunate dissociation, wrist sprain[2][1] |
| Prevention | Wrist guards[1] |
| Treatment | Not displaced: Cast[2] Displaced: Surgery[2] |
| Prognosis | Healing may take up to six months[1] |
A scaphoid fracture is a break of the scaphoid bone in the wrist.[1] Symptoms generally includes pain at the base of the thumb which is worse with use of the hand.[2] The anatomic snuffbox is generally tender and swelling may occur.[2] Complications may include nonunion of the fracture, avascular necrosis of the proximal part of the bone, and arthritis.[2][1]
Scaphoid fractures are most commonly caused by a fall on an outstretched hand.[2] Diagnosis is generally based on a combination of clinical examination and medical imaging.[2] Some fractures may not be visible on plain X-rays.[2] In such cases the affected area may be immobilised in a splint or cast and reviewed with repeat X-rays in two weeks, or alternatively an MRI or bone scan may be performed.[2]
The fracture may be preventable by using wrist guards during certain activities.[1] In those in whom the fracture remains well aligned a cast is generally sufficient.[2] If the fracture is displaced then surgery is generally recommended.[2] Healing may take up to six months.[1]
It is the most commonly fractured carpal bone.[3] Males are affected more often than females.[2]
- ^ a b c d e f g h i "Scaphoid Fracture of the Wrist". AAOS. March 2016. Archived from the original on 24 September 2017. Retrieved 12 October 2017.
- ^ a b c d e f g h i j k l m n o p q r Phillips TG, Reibach AM, Slomiany WP (September 2004). "Diagnosis and management of scaphoid fractures". American Family Physician. 70 (5): 879–884. PMID 15368727.
- ^ Tada K, Ikeda K, Okamoto S, Hachinota A, Yamamoto D, Tsuchiya H (2015). "Scaphoid Fracture--Overview and Conservative Treatment". Hand Surgery. 20 (2): 204–209. doi:10.1142/S0218810415400018. PMID 26051761.