Scaphoid Fracture
Introduction:
A scaphoid fracture, also known as a navicular fracture, occurs when one of the small bones in the wrist (carpal bones) breaks. This fracture usually occurs due to a hard fall on an outstretched hand. These fractures are common in the sports world, and can severely hinder athlete performance. Let's dive into the specifics of scaphoid fractures and break down the mechanisms behind the injury, how to combat it, and the road to recovery.
Anatomy:
The portion where the hand meets the wrist consists of the carpal bones and the radius and ulna. The scaphoid is a carpal bone located on the thumb side of the wrist. Its primary function is to provide motion and stability to the wrist joint. Another reason the scaphoid is an essential part of the wrist is that it connects the distal carpals (located near the fingers) to the proximal carpals (located near the wrist). The easiest way to identify your scaphoid is by using a “thumbs up” or “hitch-hiker thumb” position. The tendons of the thumb near the back of your wrist will create a hollow, indicating that the scaphoid is located there.
Fracture:
Scaphoid fractures are split into a few categories depending on the location of the fracture. Often, the scaphoid will break at the “waist,” or the mid portion. However, these fractures can also occur at the distal and proximal spectrums of the scaphoid.
Non-displaced fracture: Bone fragments are lined up correctly
Displaced fracture: Bone fragments have moved out of their normal position. Gaps between pieces of bones may be present, and some may overlap with each other.
The most common cause of scaphoid fractures is immense pressure on the palm in an outstretched hand position during a fall. Individuals of all ages are susceptible to these fractures.
Symptoms:
Pain
Swelling
Tenderness
Limited wrist mobility
Bruising
A deformity or bump
Sports with the highest risk of scaphoid fracture:
basketball
football
snowboarding
skateboarding
cycling
gymnastics
What to do following the fracture:
Scaphoid fractures can be extremely painful and dangerous, but here is a list of steps to follow once you attain the injury:
Stop all activity: If the scaphoid is already damaged, continuing physical activity will only cause even more harm and potentially worsen the condition. Instead, stop all forms of activity immediately and seek assistance from an athletic trainer or coach nearby.
Seek medical attention: An X-ray is a great way to determine the severity of the injury and which route to take moving forward. With an X-ray, you can clearly see whether or not it is the scaphoid that is damaged and what exactly happened on a local scale. Seeking medical attention should always be a priority if wrist pain becomes severe.
Follow Medical Advice: Following a visit to a medical professional, they will often provide you with guidelines and advice moving forward. Listen closely to what they have to say about your particular scaphoid injury and how you can treat it in order to restore your full athletic potential.
The Road to Recovery:
One of the most difficult parts of scaphoid fractures is the lengthy recovery period. If treated properly, scaphoid fractures require an average of twelve weeks to heal and six months if the diagnosis is delayed. It has been proven that using casts for non-displaced injuries remains a safe and viable method for recovery, and allows for near-100% healing rate. The cast will extend from the midportion of the thumb to the elbow for a six-week period, after which it will be removed. Another cast is then put in place, and X-rays are taken to monitor the injury. For displaced fractures, open surgery is required to hold the bones together until they fully heal. An incision will be made on the palm side of the hand, and the surgeon will use wires or a screw to fix the fracture. The surgeon will occasionally need to use bone graft, which is obtained from the wrist and/or pelvis. After either of these procedures and paths, rest and patience are key. Only time will tell when you can return to your sport, but allowing your body to heal is always the most important factor that will help bring you back.
Conclusion:
All in all, scaphoid fractures can be incredibly detrimental to an athlete’s performance. However, there are many routes athletes can take in order to ensure optimal recovery and regain their full potential. By utilizing the methods provided in this article, athletes can persevere through scaphoid fractures and not let these injuries get the best of them.
Sources:
Professional, Cleveland Clinic medical. “Scaphoid Fracture: Symptoms, Causes & Treatment.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/22240-scaphoid-fracture. Accessed 4 Feb. 2024.
“Scaphoid Fractures and Nonunion: Wrist Fractures and Treatment.” Hospital for Special Surgery, www.hss.edu/conditions_scaphoid-fractures-nonunion-wrist-fractures.asp#:~:text=The%20peculiarity%20of%20its%20blood,if%20the%20diagnosis%20is%20delayed. Accessed 4 Feb. 2024.
Winston, Mark J, and Andrew J Weiland. “Scaphoid Fractures in the Athlete.” Current Reviews in Musculoskeletal Medicine, U.S. National Library of Medicine, Mar. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5344853/.