Broken bones are usually painful and traumatic. Yet not all breaks are created equal. In some cases, broken bones that are merely uncomfortable are actually worse. This is what happens with some wrist fractures – most notably scaphoid fractures. So what are the signs, what are the treatments, and what are the risks if you ignore a break?
Pain in the Wrist
Take a moment to look at your wrist. You probably won’t be surprised to learn that it’s a collection of tiny bones. Just turning your hand in a clockwise motion reveals some of them. These tiny round bones are called carpals – eight bones that form two rows in the wrist. Shaped like a cashew and prone to injury, the scaphoid is part of this collection and the most frequently injured.
The primary way people injure their wrist is during a fall. As they head toward the ground, they instinctively stretch out their hands. This is known as a “FOOSH” or “Fall On an OutStretched Hand.” The wrist often takes the brunt of the impact – leading to a break.
Younger people are at risk because of their developing bones, and the elderly are vulnerable because their skeletal structure is often deteriorating. The best prevention for osteoporosis – and the broken bones it causes – remains calcium, Vitamin D, and a generally balanced diet throughout one’s life. For both the young and old, the type of balance and agility training provided in the martial arts or ballet can help reduce the risk of injury.
Young male athletes are prone to scaphoid fractures. Unfortunately, it can be difficult to tell the difference between a fracture and a sprain. Worse, many young men are trained to “tough it out.” When it comes to potential breaks, this is terrible advice! Shortly after a fall, the injured person may experience pain along several areas including the wrist and the indentation at the thumb’s base called the “snuffbox.” Attention should be paid to any pain that is dull, deep, or gets worse whenever you try to grip an object. For wrist injuries, the difference between a sprain and a break is often mobility. If you can still move the wrist through its usual range of motion, it is more likely to be a sprain. Swelling without significant bruising around the injury is another sign more commonly seen with a sprain.
The bottom line is that a medical professional should be seen after any fall that results in wrist pain. Even doctors need X-rays or MRIs to positively diagnose a scaphoid fracture. Yet ignoring it can lead to a non union (the bone doesn’t ever “knit together”) or worse, avascular necrosis. This occurs when the break cuts off the blood supply – slowly killing the bone from the inside. If left untreated for years, this can lead to complete wrist collapse known as a “SNAC” (scaphoid non union advanced collapse) wrist. Less serious but still consequential, the break could heal improperly.
Treatment includes surgical and nonsurgical options. If the bones are displaced, surgery is often the only option. Generally speaking, if the bones remain in position they can be set in a cast. Unfortunately, among broken bones, scaphoid fractures have some of the longest healing times because of poor blood supply to this bone. Some who have experienced this break have to wear a cast for six months. For this reason, even non-displaced fractures may be recommended to undergo surgical treatment.