You should try to stop smoking if you have a scaphoid fracture, in order to allow the best possible chance of healing. The blood supply to the scaphoidģ) Smoking. There is a strong association between smoking and non-union (failure of healing) of the scaphoid.
The near end of the scaphoid therefore has a poor blood supply and a fracture can easily cut it off preventing healing. A cyst may form at the fracture site as the joint fluid can promote breakdown of bone – the fracture is then unlikely to heal and surgery is often recommended.Ģ) Blood supply to the bone. Blood, which is essential for healing, is supplied from the far end of the scaphoid, and runs back down the bone towards the wrist. There are several factors which influence the speed of the bone healing:ġ) Fracture displacement – in an unstable injury the normal lubricating wrist joint fluid can circulate between the gap between the bone ends. the wrist may still be a bit stiff and sore for anything up to to a year.Īround 10%-15% do not heal i.e. Once healed, many scaphoid fractures continue to give nuisance symptoms i.e. This process can take anything from a few weeks up to around 4 or 5 months. The majority (around 85% – 90%) of scaphoid fractures heal when immobilised in a plaster cast. The wrist pain and swelling usually settle within the first 6-12 weeks. When the scaphoid bone breaks, there is usually pain over the thumb side of the wrist, but often the whole wrist will be involved and may swell up. The bone still moves as one unit.Ģ) Unstable injury. The broken parts of the bone do not move together – a gap between the bone ends which do not line up perfectly is often seen on X-ray. When the scaphoid bone breaks, it can be in one of two ways:ġ) Stable injury. Everything is still in the right place in a stable scaphoid fracture, and the bone simply has a crack going through it which can be difficult to see on X-ray.
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