Scaphoid Fracture: The Hidden Wrist Injury That’s Easy to Miss By Dr. Kashyap Solanki – Orthopaedic & Trauma Surgeon, Mumbai.
Updated: Oct 9
The scaphoid is the most commonly broken carpal bone in the wrist, and it is often mistaken for a sprain. Because its blood supply is fragile, a missed scaphoid fracture can fail to heal or lead to arthritis. Any wrist pain after a fall onto an outstretched hand deserves a proper check.
How It Happens
Most scaphoid fractures follow a fall onto an outstretched hand with the wrist bent back. They are common in young adults, two-wheeler riders, and people who play cricket, football or gym sports.
Signs to Watch For
Pain and tenderness in the hollow at the base of the thumb (the "anatomical snuffbox")
Swelling on the thumb side of the wrist
Pain when gripping, pinching or turning the wrist
Bruising may be mild or absent, which is why it is missed
Why It Is Easy to Miss
Up to one in five scaphoid fractures does not show on the first X-ray. If symptoms suggest a fracture, the wrist is usually splinted and re-imaged in 10 to 14 days, or an MRI or CT scan is done straight away.
Why Early Treatment Matters
Blood enters the scaphoid mainly from one end. A fracture through the middle or upper part can cut off supply to the other piece, leading to:
Non-union: the bone does not join.
Avascular necrosis: part of the bone loses its blood supply.
Wrist arthritis: long-term pain and stiffness if the bone collapses.
Treatment
Undisplaced fracture of the lower (distal) part: cast or splint, healing in about 6 to 8 weeks.
Undisplaced fracture of the waist (middle): cast for about 8 to 12 weeks, or a screw for a faster return to activity.
Displaced fracture, or fracture of the upper (proximal) pole: surgery with a compression screw, healing in about 8 to 12 weeks.
Non-union: surgery, often with a bone graft, with healing over 3 to 6 months.
Surgery is usually a small procedure through a short incision, and many patients start gentle movement within days.
Recovery
Healing is confirmed with a CT scan or X-ray before full use.
Physiotherapy restores grip strength and wrist movement.
Contact sports and heavy lifting usually wait 3 months or more.
Frequently Asked Questions
Can I just strap it if the X-ray is normal? Not if the snuffbox is tender. Splint it and get a repeat scan.
Is surgery always needed? No. Many undisplaced fractures heal in a cast, but surgery may shorten recovery.
Wrist pain after a fall that is not settling? Book an assessment with Dr Kashyap Solanki at Amardeep Nursing Home, Andheri East, Mumbai. Call or WhatsApp +91 8108171796.
About Dr. Kashyap Solanki
Orthopaedic Surgeon – Andheri, Mumbai.
Dr. Kashyap Solanki specializes in hip and knee replacement, robotic-assisted knee surgery, and joint preservation procedures like HTO, arthroscopy, and ligament reconstruction. He is also known for performing complex revision joint replacements and managing challenging upper and lower limb fractures. With a focus on precision and patient-centered care, Dr. Solanki helps restore mobility and improve quality of life through advanced orthopaedic solutions.
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