HAND EMERGENCIES 24H/24 nl fr

Scaphoid fractures

Scaphoid fractures are the most common fractures in the carpal bones.

These injuries occur after a fall or a severe injury to the wrist in extension.

Scaphoid fracture: diagnosis and symptoms

The back of the patient’s wrist is swollen and painful. Touching the area where the fracture is located incurs pain, and the fracture can sometimes be seen on an x-ray of the wrist.

This examination may also be accompanied by a bone scan, a scan of the joint or an MRI scan.

For fractures that are visible in a standard x-ray, the examination may also be accompanied by a bone scan in order to detect any possible displacement.

Scaphoid fracture: treatment and progression

Medical treatment

For non-displaced fractures, a plaster will be used to immobilise the wrist for 8 to 12 weeks.

Surgery

In non-displaced fractures, osteosynthesis is achieved through percutaneous screw fixation (the screw is inserted through a 4 to 5 mm cutaneous incision under x-ray control) under local anaesthetic. The wrist is immobilised for two weeks using a removable splint. The surgical option has the advantage of a shorter immobilisation period and a quicker return to normal activity.

For fractures with displacement, the fracture must be reduced and a compression screw fitted. The period of immobilisation depends on the complexity of the fracture (4 to 8 weeks).

A lack of consolidation is the most frequent complication concerning a scaphoid fracture. It may lead to pseudarthrosis which requires a more extensive intervention (bone graft). This type of surgery is performed under general anaesthetic and the immobilisation period lasts 8 to 12 weeks.