Scaphoid Fractures & Nonunion
The scaphoid is one of the most important bones in the wrist and plays a major role in wrist stability and movement.
Scaphoid fractures commonly occur after falls onto an outstretched hand and are frequently seen in sport, farming, cycling, and manual work.
These fractures are important because the scaphoid has a vulnerable blood supply, particularly in the proximal pole. Some fractures may fail to heal (nonunion), especially if diagnosis is delayed or the fracture is unstable.
Symptoms may include:
- Pain near the base of the thumb
- Persistent wrist pain after injury
- Reduced grip strength
- Pain loading the wrist
- Delayed recovery after a “sprain”
Some fractures can initially appear subtle on x-rays, and CT or MRI scanning may be required.
Treatment depends on:
- Fracture location
- Displacement
- Stability
- Blood supply
- Patient demands
- Time since injury
Management may involve:
- Casting
- Screw fixation
- Bone grafting
- Reconstruction for nonunion
- Correction of collapse or deformity
The goal is restoration of stable healing while minimising long-term stiffness, collapse, and arthritis.
Why are scaphoid fractures important?
Scaphoid fractures can sometimes fail to heal because of limited blood supply, particularly in the proximal pole. Missed fractures or nonunion may gradually lead to collapse, altered wrist mechanics, and progressive arthritis over time.