Non-Displaced Scaphoid Fracture

Wrist Pain With Normal X-Rays

Wrist X-Ray.

This is a young man who injured his wrist while playing baseball. He fell onto an outstretched hand and had pain in his wrist.  Like many patients with, he tried to continue to play, but it quickly became apparent that something more was wrong.

Because of his symptoms he was seen by his orthopedic surgeon. The findings were:

  • Pain with movement of the wrist
  • Swelling, most noted over the back of the hand/wrist
  • Tenderness in the 'anatomic snuff-box' at the base of the thumb

The orthopedic surgeon obtained x-ray studies to evaluate for a possible scaphoid fracture....

MRI of Scaphoid Fracture

This is the MRI image of a patient with wrist pain. The x-rays were normal, but the MRI clearly shows a scaphoid fracture (black line through the scaphoid bone).

A MRI test was obtained and clearly shows a scaphoid fracture. The fracture is non-displaced (not out of position). The scaphoid fracture is in the proximal pole--the region closer to the wrist than the hand. Scaphoid fractures in the proximal pole are especially prone to avascular necrosis. Therefore, surgery was recommended in an effort to ensure healing of this patient's scaphoid fracture.

Fixation of a Scaphoid Fracture

The scaphoid fracture was surgically held in place with a metal screw inserted into the bone.

A metal screw was placed across the scaphoid fracture to stabilize the broken bone. By using a screw to fix the scaphoid fracture, the risk of non-helaing is not eliminated, but it is reduced. In patients with scaphoid fractures of the proximal pole (as was the case here), early surgical fixation may be recommended.

Because of the difficulty many patients experience with bone healing after a scaphoid fracture, many patients, often younger athletes, will opt for a surgical procedure to ensure the healing process is more predictible.

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