Scaphoid fracture
Navicular fracture / carpal bone fracture

The scaphoid fracture is the most common fracture of the wrist joint. It involves a break (fracture) of the carpal bone located on the thumb-side of the wrist.

The scaphoid bone is also referred to as the 'navicular bone'.

Description of the condition

The hand and forearm are connected by a number of carpal bones in the wrist. These are small bones that allow supple movement of the wrist. An important carpal bone that is located on the thumb-side is called the 'scaphoid bone' (also 'os scaphoideum' or 'navicular bone').

The scaphoid bone is quite easy to localise in your own hand. When the thumb is moved outwards, this creates a triangular hollow between the two tendons on the thumb-side of the hand. This is referred to as the 'anatomical snuff box'. The scaphoid is located directly beneath this hollow. Swelling of the wrist or hand can make the anatomical snuff box less clearly visible.

This bone is broken in the case of a scaphoid fracture. This fracture usually heals slowly and can result in various additional injuries. For example, there is an increased risk of avascular bone necrosis. This is when the bone tissue dies as a result of decreased blood flow.

Cause and origin

The fracture usually occurs as a result of a fall on the outstretched hand with an over-extended wrist. It is common in people who skate, rollerblade, snowboard, skateboard or play a contact sport.

Signs & symptoms

• Pain in the 'anatomical snuff box' along the thumb-side of the hand/wrist.
  
• Swelling.
  
• Movements of the thumb are painful.
  
• Pressure from the thumb towards the wrist can provoke the symptoms (axial pain).
  
• Movements of the wrist are limited.

Diagnosis

The fracture is not always clearly visible on X-rays. As a result, this fracture is often missed. However, it is important to recognise this fracture swiftly, in order to avoid additional injuries in the long term.

Treatment

A forearm cast is applied in the case of a strong suspicion of a fracture or when a fracture is confirmed by means of X-ray. Sometimes a surgical procedure may be required to fix or reposition the fractured scaphoid bone.

Exercises

You can check your symptoms using the online physiotherapy check or make an appointment with a physiotherapy practice in your area.

References
Nugteren, K. van & Winkel, D. (2006). Onderzoek en behandeling van de hand - het pols gewricht. Houten: Bohn Stafleu van Loghum.
Parmelee-Peters, K., Eathorne, S.W. (2005). The wrist: common injuries and management. Prim Care. 2005 Mar;32(1):35-70.