Scaphoid Fracture
Scaphoid fracture care with Dr. Steven Ward in Tucson and Oro Valley — casting or screw fixation for a break in a small wrist bone that is easy to miss and can be slow to heal.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
The scaphoid is a small, curved bone on the thumb side of the wrist. It links the two rows of wrist bones, so it matters for both motion and stability. It usually breaks in a fall onto an outstretched hand.
- Pain and swelling on the thumb side of the wrist, in the hollow at the base of the thumb
- Pain with pinching, grasping, pushing, or pulling
- Often mistaken for a sprain, because the wrist may look normal
The scaphoid’s blood supply enters near the thumb end and flows backward. Breaks in the middle (the “waist”) or the end nearer the forearm heal more slowly and are more likely to have trouble healing. Wrist pain that does not go away within a day of a fall should be checked.
Is surgery right for you?
Treatment depends on where the bone is broken and whether the pieces have shifted.
- Non-displaced breaks near the thumb end usually heal well in a below-elbow cast or splint that includes the thumb
- Non-displaced breaks in the waist or near the forearm can be treated in a cast, but it may extend above the elbow and usually stays on longer
- If the break does not show on the first X-ray, you may wear a splint or cast for 2–3 weeks and have repeat X-rays; an MRI or CT can show it sooner
Surgery is recommended when the pieces have shifted, and it may be offered for waist or forearm-end breaks to improve the chance of healing and shorten cast time.
How the surgery is done
Surgery lines the bone back up and holds it with a screw (sometimes wires or a plate) until it heals. It is typically an outpatient procedure.
- Minimally invasive screw fixation — for some patterns, a screw is placed through a very small incision using live X-ray guidance
- Open fixation — through an incision on the palm side or back of the wrist, when the pieces need to be lined up directly
- Bone graft — added in some cases to help healing, particularly when a fracture has not healed (a nonunion)
Why follow-up X-rays matter
Scaphoid fractures are more likely than most breaks to heal slowly or not at all, or to lose blood supply to part of the bone. Left untreated, these problems can lead to wrist arthritis.
Dr. Ward will track healing with X-rays or a CT scan and adjust your plan. Smoking slows or can prevent healing.
Recovery overview
Typical ranges only, based on AAOS OrthoInfo patient education. Healing time varies widely with scaphoid fractures, and Dr. Ward’s plan for you may differ.
While the bone heals
- With or without surgery, you may be in a cast or splint for up to 6 months, until healing is confirmed
- No lifting, carrying, pushing, or pulling more than 1 pound with the injured hand
- No throwing, contact sports, climbing ladders, or activities with a risk of falling on the hand
- No heavy or vibrating machinery, and no smoking
Throughout recovery
- Keep full finger motion; move the fingers several times a day
- Elevate the hand to control swelling, especially early on
- Follow-up X-rays or CT scans to confirm healing
After healing
- An exercise program, sometimes with a hand therapist, to regain wrist motion and strength
- Wrist stiffness is more common after long casting or more extensive surgery
- Some people do not regain all of their previous motion and strength
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- Fingers that turn pale, blue, or cold
- Numbness or tingling in the hand or fingers that does not go away once the nerve block or numbing medicine has worn off, or that is getting worse
- A cast, splint, or dressing that feels too tight: throbbing pain, swelling, or numbness under it that does not ease after you raise your hand above your heart and gently move your fingers. Do not cut or remove a cast yourself
- Pain that is not controlled by your prescribed medication, elevation, and ice
It is normal for the hand and fingers to be swollen, bruised, and sore for a while, and for the hand or arm to stay numb and weak for several hours after a nerve block or numbing medicine. Keep your hand raised above your heart, and move the fingers that are not splinted as you were shown. Call if something feels different from what you were told to expect.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Wrist fracture (distal radius)
Dr. Ward’s broken-wrist page: splint care, swelling control, and the week-by-week rehab plan.
Open pagePatient resources
Surgery packets, pre-op and post-op instructions, exercise guides, and videos in one place.
Open pagePost-op packets
Dr. Ward’s post-operative instructions and packets, organized by joint.
Open pageExercise guides
Hand & wrist handouts, including carpal tunnel exercises and hand and finger exercises.
Open pageOrthoInfo: Scaphoid fracture of the wrist
Patient education on scaphoid fractures from the AAOS.
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