What is a Scaphoid Fracture? Causes, Symptoms, and Treatment

You're biking through the park, feeling the wind against your face, when suddenly—crash—you land hard on your outstretched hand. At first, it just feels sore, but hours later, the dull ache turns into a deep, persistent pain near your thumb. Swelling sets in, and gripping anything becomes a struggle.

You wonder if it’s just a sprain, but what if it’s something more? What is a scaphoid fracture, and why does it often go unnoticed? This small but crucial wrist bone is prone to fractures, especially from falls, and if left untreated, it can lead to long-term complications.

What is a scaphoid fracture?

A scaphoid fracture is a break in the scaphoid bone, a small, boat-shaped bone located near the base of the thumb in the wrist. It plays a key role in wrist movement and stability, making it one of the most commonly fractured wrist bones. This injury usually happens when someone falls onto an outstretched hand, forcing the wrist backward and putting too much pressure on the scaphoid.

In simple terms, this is one of the wrist conditions where a tiny but important bone in your wrist cracks, often without looking too serious at first. Unlike a broken arm, there’s usually no obvious deformity—just pain, swelling, and trouble moving your wrist. But if ignored, it can lead to long-term issues like arthritis or poor motion.

Aside from what is a scaphoid fracture, you also want to know the symptoms. Some common symptoms of a scaphoid fracture:

• Pain near the base of the thumb: Especially when gripping or pinching objects.

• Swelling and tenderness: Typically on the thumb side of the wrist.

• Limited wrist movement: Difficulty bending or twisting the wrist.

• Pain that worsens with pressure: Pushing on the wrist or thumb may increase discomfort.

• No visible deformity: Unlike other fractures, the wrist may look normal but still be fractured.

If you experience these symptoms after a fall or injury, it’s best to see a doctor to rule out a scaphoid fracture before it leads to complications.

Is a Scaphoid Fracture Serious?

Yes, a scaphoid fracture is serious, even though it might not initially seem that way. Many people mistake it for a simple sprain because there is often no immediate swelling or bruising or deformity. However, this small bone has a limited blood supply, making healing more complicated than other fractures. If ignored, it can lead to persistent pain and reduced wrist function over time.

One major complication is nonunion, which means the bone doesn’t heal. Because of the scaphoid’s poor blood flow, fractures can struggle to repair themselves, leading to chronic pain and weakness. The bone may remain broken without proper fracture treatment, affecting grip strength and overall wrist movement. This can make even simple tasks—like opening a jar or typing - painful and difficult.

So, what happens if a scaphoid fracture is left untreated? If left untreated for too long, it can also lead to avascular necrosis, where parts of the bone die due to a lack of blood supply. This increases the risk of arthritis, which causes stiffness and long-term discomfort in the wrist. Early diagnosis and treatment are crucial to prevent permanent damage and restore full function.

Does a Scaphoid Fracture Need a Cast?

Other than just what is a scaphoid fracture, one of the most searched questions is - does it need a cast? Yes, in most cases, a scaphoid fracture does need a cast. Since this bone is crucial for wrist movement, immobilization is key to ensuring proper healing. A cast helps keep the wrist and thumb stable, preventing unnecessary movement that could delay recovery. The type of cast and the duration of wearing it depends on the severity and location of the fracture.

A short arm thumb cast is usually enough for minor, non-displaced fractures - where the bone is still aligned. This type of cast extends from the elbowto the thumb and holds everything in place for about 6–12 weeks. However, if the fracture is more complex, doctors should recommend surgery, improving the chances of proper healing.

In some cases, when a fracture isn’t healing well with a cast alone, surgery might be necessary. Surgeons use a screws to hold the bone together, followed by a shorter period in a cast. Without proper immobilization, the risk of complications—like nonunion or avascular necrosis—rises, making early and appropriate treatment essential.

What is the Best Treatment for a Scaphoid Fracture?

The best treatment for a scaphoid fracture depends on its severity. For minor, non-displaced fractures, wearing a cast for several weeks can be enough. This keeps the bone stable and allows it to heal naturally. Regular check-ups and imaging help ensure that the fracture heals correctly without complications.

However, for more serious fractures - especially when the bone is displaced—surgery is necessary. Surgeons often a screw to compress the fracture fragments together, reducing the risk of nonunion. This is especially important for those with demanding lifestyles, such as scaphoid fractures in athletes, where quicker recovery and full wrist function are crucial for returning to sports.

Rehabilitation is also a key part of treatment. After the cast or surgery, physical therapy helps restore wrist strength and flexibility. Without proper rehab, stiffness and weakness can linger, making everyday tasks harder. Whether treated conservatively or surgically, early intervention ensures the best possible recovery and reduces long-term complications.

How Long Does It Take for a Scaphoid Fracture to Heal?

The healing time for a scaphoid fracture varies, but with proper treatment, it typically takes 6 to 12 weeks. However, some fractures - especially those that are more severe or located in areas with poor blood supply - can take several months to fully heal. Early diagnosis and proper immobilization play a big role in speeding up recovery.

Several factors can affect the recovery rate, including:

• Location of the fracture: Breaks near the thumb side heal faster, while those closer to the wrist take longer due to poor blood supply.

• The severity of the fracture: Non-displaced fractures heal quicker than displaced or shattered ones.

• Treatment method: Cast treatment takes longer, while surgery with a screws speeds up recovery.

• Blood supply to the bone: Limited blood flow can slow healing and increase the risk of complications.

• Age and overall health: Younger individuals and those with good bone health tend to heal faster.

• Smoking and lifestyle habits: Smoking and poor nutrition delays bone healing.

Following a doctor’s advice, wearing a cast as instructed, and avoiding strain on the wrist can all help ensure a smoother and faster recovery.

Wrap up

Although a scaphoid fracture may seem minor at first, without proper treatment, it can lead to long-term wrist problems. If you’ve fallen on your hand and feel persistent pain near your thumb, it's crucial to get checked.

What is a scaphoid fracture? It’s a break in a small but important wrist bone that requires early diagnosis and proper care. Whether treated with a cast or surgery, following medical advice ensures the best recovery. Ignoring it can lead to complications like nonunion or arthritis, making daily tasks painful. Taking it seriously from the start is the key to full healing.

“Scaphoid fractures can be easily overlooked due to a lack of swelling, bruising, and deformity after a fall.  However, the pain of the scaphoid fracture is usually the only symptom.  These fractures unfortunately can be very difficult to successfully treat due to the scaphoid's poor blood supply.  If not identified, the bone will not heal and eventually arthritis develops.  It is imperative to obtain x-rays to identify the fracture and take necessary steps to ensure it is successful healing which would give the patient the best possible outcome.”- Dr. Christian Zaino

Don't let a scaphoid fracture go untreated - schedule a consultation with the Orthopedic Institute of NJ to explore your treatment options today!

„

Scaphoid fractures can be easily overlooked due to a lack of swelling, bruising, and deformity after a fall. However, the pain of the scaphoid fracture is usually the only symptom. These fractures can be difficult to treat due to the scaphoid's poor blood supply. If not identified, the bone will not heal and eventually arthritis develops. It is imperative to obtain x-rays to identify the fracture and ensure proper healing for the best possible outcome.

Christian J. Zaino, MD, Orthopedic Surgery, Hand & Wrist
Hand & Upper Extremity Center