Overview

The scaphoid is a one of the key bones in our wrist. It sits between our thumb and forearm and plays an important role in the function of our wrist. A common injury to the scaphoid bone is a fracture, it accounts for 82-89% of all wrist bone fractures.

Mechanism of injury

For a scaphoid fracture to occur, a significant external force is required, typically seen with a fall on an outstretched hand. The impact from a fall causes the scaphoid bone to compress into the radius (forearm bone), resulting in fracture most likely to occur in the middle of the scaphoid. 2 major ligaments attached to the bone are also at risk of injury as well.

Symptoms

- Swelling in the anatomical snuffbox

- Reduction of 50% in grip strength compared to the other hand

- Pain on palpation in the anatomical snuffbox

Diagnosis

There is currently no reliable clinical test to diagnose a scaphoid fracture, rather a combination of mechanism of injury, symptoms and imaging are used. X-ray is often the first imaging tool utilised to further examine the possibility of a scaphoid fracture, initial x-rays can detect up to 70% of all cases, and therefore clinicians may request for repeated x-rays 10-14 days after to re-check.

Physiotherapy Treatment

For non-displaced scaphoid fractures, where there isn’t a shift of the bone during injury. The aim of treatment is to allow the fracture to consolidate and return function to the wrist. Immobilisation of the wrist with a brace or cast is often used to allow the bone to heal. The duration of immobilisation depends on the healing of the bone. Once the bone has healed rehabilitation is aimed to restore full strength and function through joint mobilisation, soft tissue manipulation and specific forearm/wrist and hand exercises.

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References

Rhemrev et al. (2011). Current methods of diagnosis and treatment of scaphoid fractures