Our hand therapists are experts in assessing and treating scaphoid fractures and broken scaphoids. With a reputation endorsed by sporting organisations like the Melbourne Football Club, and over 20 years experience, make us your first choice for scaphoid fracture treatment.
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A fractured scaphoid is a common wrist injury, many may think of it as a fractured wrist, or simply a sprained wrist. The cause is a fall on an outstretched hand where undue load is distributed through the wrist causing the small scaphoid bone to fracture or break.
Most people experience pain or swelling around the base of the thumb and into the wrist with a fractured scaphoid. In many cases it’s likely there will be no visible deformity and many dismiss the problem as a sprain and fail to seek proper medical attention and advice leading to the development of other issues.
It’s also a common injury in sporting codes like football, basketball, netball and many other sports where impact to the wrist can cause a fracture in the scaphoid. People under 50 years old are actually more likely to fracture their scaphoid in a fall on to their hand and wrist than to break their radius or ulnar (the other two wrist bones). Scaphoid fractures can vary from mild hairline fractures or more serious injury that requires surgery. Expert early diagnosis is really important in scaphoid fractures.
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View the video below to learn more about scaphoid fractures. As explained by Action Rehab founder Ben Cunningham.
Without specialist treatment for scaphoid fractures, serious complications can arise. To heal quickly you need the support and knowledge of an expert hand therapist.
Action Rehab can assess, advise, and treat broken scaphoids and seek specialist opinion when required. Our hand therapists have the ability to read X-rays and CT scans can assess medical imagery deciding the best treatment plan.
Poorly managed, a scaphoid fracture may never heal creating problems later in life and the possible need for reconstructive surgery. It’s these complications that make your decision to visit a hand therapist important. It’s so you get the right brace/splint/cast, treatment, therapy, and exercises for the specific scaphoid fracture you have.
Because of its location, blood supply, and possible damage to blood vessels around the broken scaphoid can cause the healing process to slow, sometimes taking months. Depending on the damage, a broken scaphoid may respond differently and those with a non-displaced injury may be placed in a cast or splint where recovery times could be around 6-8 weeks.
It is important to consult an expert hand therapist as soon as you suspect a scaphoid fracture or a fall on the outstretched hand as they can best assess the stability of the fracture and the need for immobilisation, thumb in or out or surgery. Some scaphoid fractures do not require plaster and stable fractures may only require a wrist brace with no thumb immobilisation and no plaster required. There are cases where splinting as opposed to plaster casting can improve the speed of healing the fracture. Our therapists are experienced in scaphoid fractures and their treatment and can offer you the best advice if you suspect you may have this injury.
Hopefully, you will never wear a “cast” for a scaphoid fracture. Modern technology and treatment mean that we no longer need to tolerate a plaster or fibreglass “cast” and patients are much happier and much more comfortable when treated in a thermoplastic water resistant “cast” or splint that can be worn 100% of the time (just like a traditional “cast”. Some Dr’s think “splint” means removal but in fact, at Action Rehab, we can fabricate a “splint” that works just like a really light “cast” and the patient experience is much better and the treatment outcomes and healing are actually faster.
A scaphoid that is immobilised including the thumb is actually slower to heal than one treated with the thumb free.
We can fabricate a “splint” that works just like a really light “cast”. Patient experience is much better and the treatment outcomes and healing are faster with the thumb free to mobilise.
See below for before and after photos. This patient came to us with a traditional cast. We were able to fit them with a lightweight waterproof functional brace.
Action Rehab is a leading hand therapist Melbourne have relied on for more than 20 years, with a reputation endorsed by sporting organisations like the Melbourne Football Club and many other institutions.
Known for providing treatment of scaphoid fractures and other hand, wrist, elbow and shoulder injuries Action Rehab are the hand therapists that Melbourne trusts.
How common are scaphoid fractures, and how do they happen?
Scaphoid fractures predominantly occur in young, active individuals, most commonly resulting from a fall on the outstretched hand. The scaphoid bone is the most important carpal bone in your wrist. Scaphoid fractures account for 79% of carpal fractures making it the most commonly injured bone in young adults.
How long does it take for scaphoid fractures to heal?
This depends on how it is managed and assessed. A poorly managed fracture can lead to non-union and never heal causing other wrist problems and need reconstructive surgery later in life. An undisplaced fracture of the scaphoid waist or distal (closer to the thumb) will heal within 8 weeks if it is managed well, with microtrauma and a well fitting wrist splint. A distal pole fracture of the scaphoid will actually heal even faster than that and may heal within 6 weeks if managed well. Some scaphoid fractures are more complicated, and we will assess and advise on the best management of the fracture and if required we can refer you to an excellent surgeon who will operate on the scaphoid bone where required. A surgically repaired scaphoid should heal within 8 weeks as long as the repair is stable and the management is done in a wrist splint with the thumb free.
Can a scaphoid fracture heal on its own?
Yes, an undisplaced scaphoid fracture can heal without surgery as long as it is managed well in a splint. A displaced fracture or a fracture proximal (nearer the wrist) to the waist of the scaphoid generally needs surgical assessment and may require surgery to assist with healing. Post surgery a scaphoid is considered stable, so the treatment is then the same as for non-surgical scaphoid fracture.
How is a scaphoid fracture treated?
Scaphoid fracture treatment depends on where the fracture/break is, treatment varies from the level of the fracture tip to toe, however generally if the fracture is stable or has been stabilised with surgery then treatment is best in a water resistant wrist splint/cast (that can be removed if requested or can be secured to not be removed if it is indicated) with the thumb free to mobilise. Exercises will start as soon as the fracture is healing (usually 6-8 weeks post injury) and strengthening will commence once the fracture is considered “healed”. The best way to assess a fracture and its healing is to do a CT scan normally at the 8-week mark post injury. A CT scan will show the degree of healing but is unlikely to show “complete” union at the 8-week stage. Generally where there is a bridge on “union” measured on the CT then the fracture is likely to continue to heal and will not lead to “non-union” which is the main complication of a scaphoid fracture.
Do scaphoid fractures require surgery?
Generally, the answer is no. However, where there is significant displacement of the fracture then surgery is indicated. Surgery can also speed recovery in some cases and in those proximal pole fractures then a surgical assessment is important. We are able to read X-rays and CT scans and can advise where a surgical opinion is required.
What is the fastest way to heal a scaphoid fracture?
The fastest way to heal a scaphoid fracture is with expert assessment of the fracture type and then balancing rest in a splint/cast with gentle movement and micro stress. A scaphoid that is immobilised including the thumb is actually slower to heal than one treated with the thumb free.
Is a scaphoid fracture serious?
Yes if a scaphoid fracture is left untreated or poorly managed in a cast or fibreglass thumb spica splint then it can lead to serious complications, bone graft surgery, wrist reconstruction, bone removal. It is a really important bone in the wrist and needs the hand experts to assess and advise.
How long do you wear a cast for a scaphoid fracture?
Hopefully you never wear a “cast” for a scaphoid fracture. Modern technology and treatment mean that we no longer need to tolerate a plaster or fibreglass “cast” and patients are much happier and much more comfortable when treated in a thermoplastic water resistant “cast” or splint that can be worn 100% of the time (just like a traditional “cast”). Some Dr’s think “splint” means removal but in fact, at Action Rehab, we can fabricate a “splint” that works just like a really light “cast” and the patient experience is much better and the treatment outcomes and healing is actually faster.
This information has been verified by Action Rehab director Ben Cunningham.
Ben Cunningham is currently the Hand Therapist at Melbourne Football Club (AFL) and the director of Action Rehab. Ben has over 20 years’ experience providing hand and upper limb therapy, including working in the United Kingdom at the Queen Victoria Hospital and as the senior clinician at the Alfred Hospital in Melbourne.