Fracture of the scaphoid is the most common hand fracture. The scaphoid is a bone at the base of your thumb. It is a fracture that occurs when falling on the outstretched hand. The nature of a fracture needs to be assessed with at least an x- ray. If a scaphoid fracture is suspected but the x- ray returns a normal result then a CT scan is required to rule out a scaphoid fracture.
Most fractures can be treated conservatively with immobilisation such as casting however, if there is too much displacement or angulation in the fracture making the fracture unstable, surgery may be recommended.
Fractures in kids generally take 4- 6 weeks to heal and fractures in adults generally take 6- 8 weeks to heal.
What is the usual mechanism of injury?
- Fall onto an outstretched hand
Signs and symptoms of a fracture
- Pain on palpation in the anatomical snuffbox
- Pain may settle quickly after the incident
- Pain with axial loading of the thumb
- Night pain may be present
- Swelling may be present
- Movement and use of the wrist and thumb may be painful
- Grip strength may be reduced
What does the science currently say?
- Blood supply to the scaphoid originates distally so blood flow to the proximal pole may be reduced in a scaphoid fracture particularly if the fracture is significantly displaced. This can lead to necrosis of the fragment that does not get enough blood supply
- Non- union is also common due to the poor blood supply of the scaphoid. Surgery may be recommended in these situations
How can Physiotherapy help?
Your Physiotherapist will be able to:
- Apply and remove fibreglass casting
- Treatment following casting
- Treatment following surgery
- Provide manual therapy to reduce pain, tightness and improve movement
- Guide you through strengthening exercises to improve the capacity, endurance and strength of these tendons to be able to handle the loads of activities that you need to perform