The scaphoid bone is located in the palm under the small dent at the base of the thumb. The scaphoid bone is the biggest of eight small bones located at the wrist joint which create the harmonic and smooth movement of the joint at all movement ranges.
The scaphoid bone is mostly covered with cartilage, limiting its blood supply to two distinct places and thus when the fracture occurs across the scaphoid bone the blood vessels within it might be cut off and then half a bone may end up without blood supply, possibly leading to degeneration and to the "death of the bone".
How is a Scaphoid Fracture created?
The main reason for a scaphoid fracture is a fall where the hand is stretched forward to stop the fall. Due to its size and location, this bone "absorbs" the fall's energy. Due to the way this bone is fractured, which is typically a fracture with no motion of the bone's two parts, a minimal fracture line is created, making it difficult to diagnose in X-Ray Radiography.
I fell, what should I do?
Orthopedic examination, X-Ray Radiography, and applying a cast to the wrist from the thumb to the elbow for two weeks.
The way the fracture is formed and the scaphoid bone's shape make it difficult to see the fracture in X-Ray Radiography immediately after the impact. In case of movement of the bone's two parts it is possible to see the fracture.
After the injury, the bone's two parts return to their place, usually without movement, and when they are not fixed in a cast every movement of the wrist opens and closes the fracture, and without being felt causes the liquid surrounding the palm fingers to infiltrate the bone and prevent the sticking (healing) of the two parts.
The movement may also cause a tear in the blood vessels inside the bone if they were not torn directly by the impact, possibly cutting off the blood supply to one of the two parts and thus increasing the chances for gangrene of the bone.
the orthopedist removes the cast approximately two weeks after the injury, and feels the area with his hand, and then refers the patient to repeated Radiography of the location.
Due to natural changes in the fracture's edges, the chances to see the fracture in X-Ray Radiography increases with time. CT imaging is used in case the fracture is invisible, but the pain still exists, which thanks to its characteristics is almost certain to locate a fracture in the bone, if any exists.
If no fracture is found after two weeks by feeling the hand and by X-Ray Radiography, it is possible to say that the treatment prevented the risk which might have been caused by an untreated fractured bone.
A scaphoid fracture rarely causes disfigurement or internal bleeding and the pain may subside within a few days, and therefore there are cases where no physician is consulted for examination following an impact.
Scaphoid Fructure – Recovery
The recovery process from scaphoid fracture is a sensitive matter. The scaphoid bone is a bone which is difficult to heal and the process is particularly slow.
Full recovery from a fracture in a long bone such as the wrist bone takes approximately 6 weeks, while the recovery from a scaphoid fracture may take 8. 10. 12 weeks or even more.
There are cases in which the bone will not heal due to insufficient blood supply, which may lead to the bone's death and to a degenerative illness of the palm.
Scaphoid fracture surgery may hasten the healing and prevent movement. In the surgical operation, a small screw is inserted into the fractured bone, with a bone implant, in order to assist the bone cells in healing the bone. The screw creates internal pressing of the two parts of the bone one towards the other and reduces the healing time.
It is generally recommended to operate on a scaphoid bone in order to reduce the healing time and to prevent complications.