Scaphoid Fracture

INTRODUCTION

The scaphoid bone is one of the eight small bones that make up the “carpal bones”of the wrist.There are two rows of  bones,one closer to the forearm(proximal row)and the other closer to the hand (distal row).The scaphoid bone is unique in that it spans the two rows.This puts it at extra risk during injury,which accounts for it being the most commonly fractured carpal bone by far.

CAUSES

Most scaphoid fractures occur when you stretch your hand out in front of you to protect yourself from a fall. They can also occur when your wrist twists severely or is hit very hard. Scaphoid fractures often happen while a person is playing sports such as football, soccer, or basketball or during activities such as Rollerblading, skateboarding, or bike riding. They can also occur as a result of a car accident or a punching incident.

CLINICAL FEATURES

  • Because most scaphoid fractures do not cause the wrist to look broken and many cause only minor symptoms, it can be hard to know if your scaphoid bone is broken. If the bone is broken, you may have:
  • Pain, tenderness, or swelling on the thumb side of your wrist.
  • A hard time grabbing or gripping things or moving and twisting your wrist or

Thumb.

  • Bruises around your wrist.

It can be hard to tell the difference between a wrist that is sprained and one that is broken. If you have fallen on an outstretched hand and your wrist hurts, be sure to see a doctor to find out if you have any broken bones. Scaphoid fractures that are not treated properly can lead to long-term problems.

DISPLACEMENT:

  • Displaced
  • Undisplaced

DIAGNOSIS:

Your doctor will ask you questions about your symptoms and about how and when you hurt your wrist. He or she will then look at your wrist, find any swollen or tender areas, and see how well you are able to move your wrist and thumb. Your doctor will also try to find out how well blood is flowing to your hand and if you have any nerve damage in your wrist. On examination,one may be able to elicit tenderness in the scaphoid bone.

Radiological Features.

Whenever suspected,an oblique view of the wrist,in addition to the antero-posterior and lateral,is essential.Sometimes,it is merely a crack fracture and is not visible on initial X-rays.If a fracture is strongly suspected,the X-rays should be repeated after 2 weeks.

TREATMENT:

  • If the fracture is non displaced it could be treated by immobilization in cast.the cast usually covers the forearm,wrist,thumb and sometimes includes the elbow for first phase of immobilization.although the fracture may heal in as little as 6 weeks the healing might also be delayed. One reason for this delay is variable blood supply to different parts of scaphoid bone.the fracture can disrupt the bones blood supply and delay the healing.part of bone may even die after fracture due to loss of its blood supply particularly in its proximal thirds the part closest to forearm.
  • If the fracture is displaced surgery is recommended.with surgery screws or pins are inserted to stabilize the fracture often with the bone graft to help heal the bone.

COMPLICATIONS:

  • Avascular necrosis
  • Delayed and non-union
  • Wrist osteoarthritis

PHYSIOLINE’S SPECIALIZED PHYSIOTHERAPY HAS VITAL ROLE TO PLAY

At Physioline, all the members of the rehabilitation team work together so as to provide proper care and the therapy in order to:

  • Relief pain
  • Reduce swelling
  • Reduce stiffness
  • Strengthening of muscles around wrist
  • Prevention of complications

 

Visit Physioline for the Consultation and treatment