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Scaphoid Fracture Hand Therapy

A X-ray showing a fracture through the waist of the scaphoid

The scaphoid is one of the eight small bones in the wrist called carpal bones. It is located just below the thumb and is the most commonly fractured (broken) carpal bone.

Some areas of the scaphoid have poor blood supply and may have difficulty healing and there is higher risk of avascular necrosis for scaphoid fractures.

What are the symptoms of a scaphoid fracture?

Common symptoms include pain with movement of the wrist or thumb.

• A person may experience difficulty pinching or holding items.
  
• The thumb side of the wrist may be tender to pressure.
  
• There may also be swelling and bruising at the base of the thumb and wrist.

Sometimes there is only mild pain, and the injury is mistaken for a wrist sprain.

What causes a scaphoid fracture?

A scaphoid fracture is usually caused by a fall on an outstretched hand with the wrist bent backward.

Of course it can also be caused by a direct hit to the wrist, such as in a car accident or contact sport.

It is most common in active young adults.

What is the treatment for a scaphoid fracture?

If a scaphoid fracture is suspected, an X-ray of the wrist will be taken; however, sometimes the fracture is not seen right away.

If nothing is seen on an X-ray, the wrist may be placed in a cast or orthosis and then X-rayed again in two to three weeks.

An MRI may also be used for diagnosis.

Some fractures require immobilization in a cast or customized splint for eight weeks up to six months. The cast will include the wrist and thumb and may also include the elbow. The fingers will be free to move.

More complicated types of scaphoid fractures will likely require surgery to realign and stabilize the bone fragments.

What can a hand therapist do for me?

Our senior hand therapists may fabricate a custom orthosis to immobilize the wrist and thumb to protect the healing bone.

The therapist will also educate the patient on how to reduce pain and swelling in the hand.

When the cast is removed, hand therapy will focus on regaining motion, strength and functional use of the wrist and hand.

Example of an orthosis to protect the healing bone after a scaphoid fracture

Patients may also receive the following hand therapy treatment modalities:

• cold therapy
• heat therapy
• moist heat paraffin wax therapy
• manual therapy
• joint mobilization
• ultrasound therapy
• stretching exercises
• strengthening exercises
• scar management
• etc