DR. DANIEL AEDO MARTÍN · MADRID

Scaphoid fracture

Thumb-sided wrist pain after a fall, even with normal initial X-rays.

What it is

The scaphoid is a wrist bone on the thumb side. Its blood supply makes some fractures difficult to heal, so diagnosis and follow-up matter.

Symptoms

Pain may follow a fall onto the hand, sometimes with little swelling. Being able to move the fingers or wrist does not rule out a fracture.

Assessment

If examination suggests a fracture despite normal first X-rays, the wrist is protected and follow-up or further imaging arranged. MRI or CT is selected for the clinical question.

Non-surgical treatment

Some stable fractures can be treated with immobilisation and review. Duration depends on fracture location and healing. Smoking can impair bone healing.

When surgery is considered

Displacement, instability, certain fracture locations or failure to heal may justify surgery. Fixation and possible bone grafting are tailored to the case. Non-union, stiffness and further surgery are discussed.

Recovery and follow-up

Return to loading and sport depends on healing, not pain reduction alone. Follow-up helps adjust protection and identify healing problems.

Frequently asked questions

Does a normal X-ray rule it out?

Not always, particularly early on. Clinical suspicion may require further investigation.

Can I remove the splint once pain stops?

Not without advice. Symptom improvement does not confirm bone healing.

Does every scaphoid fracture need surgery?

No. Stability, displacement and location guide the choice between immobilisation and surgery.

Why is CT requested?

It may clarify fracture shape or healing. Each investigation addresses a specific question.

What is non-union?

Failure of the fracture to heal. Bone biology and stability must be reassessed, and treatment may differ from a recent fracture.

When can I return to sport?

When healing and function allow its demands. Hand loading and fall risk need particular consideration.