Scaphoid Fracture
Description
A fracture is a broken bone. The scaphoid is a bone in the hand at the base of the thumb which links the wrist to the hand. A scaphoid fracture is not always seen on xray. If the patient has tenderness at the base of thumb in an area called the anatomic snuff box many times the medical provider will splint the wrist and thumb as if it was fractured. Sometimes surgery is needed to realign the bones and to place a screw or wire to stabilize the bones while they heal. Severe fractures may have an associated tendon, nerve or blood vessel injury.
Symptoms
Pain, swelling, bruising of the skin, pain with movement, numbness of the thumb, inability to move the thumb, tenderness in the anatomic snuff box of the hand.
Tests
A history and physical exam will be done. An xray will confirm the diagnosis.
Treatment
Most fractures can be treated by splinting the thumb in a thumb spica splint. Sometimes a wire or screw must be placed to stabilize the bone while it heals. OTC pain medications such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin) or naproxen (Naprosyn, Aleve) can be used. Narcotic pain medications may be prescribed as well including: hydocodone and acetaminophen (Vicodin, Lortab), tramadol and acetaminophen (Ultram), or oxycodone and acetaminophen (Endocet, Percocet). If the bone punctures the skin the injury will need to be cleaned very well and antibiotics may be given to prevent an infection.
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