Scaphoid Fracture: The Hidden Wrist Injury That’s Easy to Miss By Dr. Kashyap Solanki – Orthopaedic & Trauma Surgeon, Mumbai.

Wrist pain after a fall might seem like a simple sprain — but sometimes, it’s much more. One of the most commonly missed injuries in the wrist is the Scaphoid Fracture — a tiny break that can cause major problems if not diagnosed and treated in time.

What Is the Scaphoid Bone?

The scaphoid is a small, boat-shaped bone located at the base of the thumb, between the forearm and the hand. It plays a key role in wrist movement and stability.

Due to its unique shape and limited blood supply, fractures in this bone can easily go unnoticed — and heal poorly if left unattended.

How Does a Scaphoid Fracture Happen?

Most commonly, it occurs when you:

• Fall on an outstretched hand

• Experience a sports injury (like during cricket, football, or skating)

• Have a direct blow to the wrist

At first, it may feel like a mild sprain — but the pain persists, especially near the thumb side of the wrist.

Symptoms to Watch For

• Pain and swelling on the thumb side of the wrist

• Tenderness in the “anatomical snuffbox” (the hollow between the thumb and wrist)

• Difficulty gripping or twisting objects

• Pain that worsens when lifting or pushing

Even if the pain is mild, don’t ignore it — early diagnosis prevents long-term problems.

Why Scaphoid Fractures Are Often Missed

• Initial X-rays may look normal, especially in the first few days.

• Pain may be mild, leading to misdiagnosis as a “sprain.”

• The bone’s poor blood supply means delayed healing or non-union if untreated.

That’s why persistent wrist pain after a fall should always be evaluated by an orthopaedic specialist, possibly with MRI or CT scans for accurate diagnosis.

Treatment Options

1. Non-Surgical (for small, stable fractures):

• Cast or splint immobilization for 6–8 weeks

• Regular X-rays to monitor healing

2. Surgical (for displaced or non-healing fractures):

• Internal fixation using screws

• Bone grafting in cases of delayed or non-union

Early intervention helps restore wrist motion and strength, preventing arthritis or deformity.

Recovery and Prognosis

With timely diagnosis and proper immobilization, most scaphoid fractures heal completely. However, untreated or delayed cases can lead to:

• Avascular necrosis (bone death)

• Chronic wrist pain

• Arthritis and loss of grip strength

Advice

“If you’ve had a fall on your hand and your wrist still hurts after a few days, don’t assume it’s just a sprain. A missed scaphoid fracture can silently damage your wrist over time.”