Scaphoid fracture

If you are considering surgery to fix your scaphoid bone fracture, or have an operation planned, it is important to know all you can about it. This includes:

• why you need this operation

• what it will be like

• how it will affect you

• what risks are involved

• any alternatives.

The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your choices of treatment for a scaphoid bone fracture with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.

What is the problem?

Your scaphoid bone is broken. A break is also called a fracture. There is no difference in severity between a fractured bone and a broken bone. The break may be causing pain in your wrist.

What is the scaphoid bone?

The scaphoid is one of the small bones in your wrist, near the base of your thumb.

What has gone wrong?

Fresh fracture - You broke your scaphoid bone recently. The broken pieces are not in their correct position: this is called a displaced fracture. Your scaphoid is very unlikely to heal (unite) without an operation. If your scaphoid fracture does not heal, you will have further problems.

Old fracture - non-union - It may be many months since you broke your scaphoid bone. Perhaps you did not know that you had broken your scaphoid, so you were not treated and your break did not heal. Alternatively, you may have had your wrist in a plaster cast and despite this your break has still not healed. A break that has not healed is called a non-union.

The aims

Our aim is to get your scaphoid fracture to heal with an operation.

The benefits

If your scaphoid fracture heals, most of the pain that you have should go. More importantly, you are much less likely to develop arthritis in the wrist if the scaphoid is in one piece.

Are there any alternative treatments?

If your break is out of place (displaced) or it has failed to heal (unite) after treatment in a cast, there is no satisfactory alternative treatment.

Some people try plaster for 3 months but in reality if the fracture is not healed after 8 weeks in a plaster cast it is unlikely to ever heal.

What if you do nothing?  

Fresh fracture - If the fragments of the broken scaphoid remain out of place and you do not have an operation, your fracture probably will not heal. You will then go onto have a non-union or un-united scaphoid.

Old fracture - non-union - If your scaphoid remains broken, you will probably develop arthritis in your wrist in a few years time. The joint will then become inflamed and painful.

Who should have it done?

If you have no other wrist problems you should have your fracture fixed.

Who should not have it done?

If you have had an un-united scaphoid for a long time and have developed arthritis in the wrist, you may not benefit from this operation. This depends on the severity of the arthritis.

Author: Mr Boyd Goldie MBBS FRCS BSC DHMSA. Consultant in orthopaedics & trauma.

© Dumas Ltd 2006

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