Fractures (radius/scaphoid)

What is it?

A scaphoid fracture is a break in one of the small bones of the wrist, which can occur during sports activities or motor vehicle accidents. The radius is the larger of the two bones in the forearm, and fractures in this bone are very common. There are no specific risk factors or diseases that make anyone more likely to experience a scaphoid fracture, while osteoporosis can make patients more susceptible to radius fractures.

Why does it occur?

These types of fractures tend to occur most often after a fall on to an outstretched hand, and can also happen during sports activities or motor vehicle accidents. 

What are the symptoms?

A broken wrist almost always causes immediate pain, tenderness, bruising and swelling. Sometimes the wrist may look a little deformed. 

How is it diagnosed?

Your consultant will order x-rays of the wrist to see if the bone is broken and whether there is displacement (a gap between broken bones). They can also show how many pieces of broken bone there are. Because scaphoid fractures do not always show up on x-rays, you may also need a CT or MRI scan, which will also help inform your treatment plan. 

How is it treated?

Treatment for a wrist facture can range from casting to surgery, depending on its  severity and location. Some  portions of the scaphoid have a poor blood supply, and a fracture can further impede this, so it will have to be monitored more closely. 

Non-surgical treatment

If the broken bone has not moved, plaster cast may be applied until the bone heals. But if the bone is out of alignment it may be necessary to re-align the broken bone fragments. 

Once the bone is properly aligned, a splint may be placed used the first few days to allow for a small amount of normal swelling. A cast is usually added a few days later once the swelling is reduced, and changed 2 to 3 weeks later as the swelling is further reduced.

Your consultant may monitor the healing using x-rays, according to the type of fracture you have sustained. Depending on the nature of the fracture, your doctor may closely monitor the healing by taking regular x-rays. 

Surgical treatment

If the bone has moved too far out of place, surgery may be necessary. Typically this involves making an incision to access directly the broken bones and correct the alignment. Small bone grafts in the case of scaphoid fractures are sometimes required. There are a number of options for holding the bone in the correct position while it heals, including a cast, metal pins, plate, screws, an external frame, or a combination of the above.

The One Orthopaedics team specialists

Peter Magnussen

Consultant Hand Surgeon FRCS

Anthony Hearnden

Consultant Orthopaedic Specialist FRCS (Tr & Orth)