Scaphoid fracture is common and caused by a fall on the palm of the hand. It mainly affects young adults, remains difficult to diagnose and must be treated immediately.
What is a carpal (hand) scaphoid fracture?
A scaphoid fracture is a bone that gave way under the weight of a shock. “The bone breaks because it is compressed between the wrist and the bones of the forearm at the time of the fall. The scaphoid is theone of the 8 wrist boneslocated on the heel of the hand at the base of the thumbwhich will then break into two pieces during a fall“, explains Frédérique Mazodier, hand and wrist surgeon at the French Institute of Hand Surgery in Paris. It is one of the largest of the carpal bones (wrist) It has the particularity of great mobility and extreme vulnerability during wrist trauma, which explains why fractures of this bone are common.
What are the symptoms ?
If the fractures can go unnoticed, certain symptoms must nevertheless alert, in particular “pain in the wrist, but which can fade in a week“, indicates our interlocutor. These fractures can also lead to wrist swelling, of the edema type. “You may feel a little discomfort in the wrist, and not be able to extend or bend fully in the case of movements in hypertension. However, very often, even in the event of pain, people do not have the reflex to consult, wrongly and one can very easily therefore miss a scaphoid fracture.“, insists the Doctor.
What causes a scaphoid fracture of the hand?
Falls with landing on the wrist in extension are often the cause of a scaphoid fracture of the hand. “When you fall backwards during a fall from a motorcycle, scooter or bicycle, as soon as there is high inertia, the fall can cause this fracture. Among my patients, more boys than girls are affected by this fracture”recognizes Frédérique Mazodier.
What is the healing time?
The particularity of the scaphoid lies in its difficulty in consolidating on its own. “It’s one of the longest bones to heal, you have to count 3 months of immobilization so that this bone becomes solid again without operation“. A healing time which is reduced in the event of an operation to approximately 1 month.
What exams to do?
“With this type of fracture there is the problem of visualization even with an X-ray, so you have to ask for a scanner or MRI to deepen and establish the diagnosis.“, indicates our interlocutor.
What treatment to cure a scaphoid fracture of the hand?
In the case of a scaphoid fracture of the hand, it is necessary to consult a specific hand surgeonso as not to miss this type of fracture which can generate long-term complications, in particular “chronic pseudoarthrosis, i.e. a lack of consolidationwhose processing is more random“. Once the fracture diagnosis has been established, two types of fracture are possible:
► Undisplaced fractures that can be immobilized in a splint or cast with resin. Orthopedic treatment is therefore generally recommended but may not be sufficient in the context of certain fractures. “It is then advisable to operate so that they consolidate”.
► Displaced fractures that always require radio surgery “to put the fragments back using pins or screws“. The operations are carried out in ambulatory surgery “under loco-regional anesthesia in half a day with an intervention which on average lasts 30 minutes“. And in any case, you have to quit smoking, “smoking being contraindicated in case of fracture”, insists Dr Frédérique Mazodier.
Can you drive with a scaphoid fracture of the hand?
“Legally, you can’t drive with a fractured scaphoid in your hand. Driving becomes complicated with a brace”, would like to clarify our expert. It is possible to drive again one month after the operation.
Are there any gestures to avoid?
In order to facilitate the consolidation of this bone, certain gestures should be avoided. “On can perform everyday actions while avoiding sudden movements. It is necessary to immobilize as much as possible and above all to avoid all potential sports with risk of falls: handball, basketball, boxing…” concludes Doctor Frédérique Mazodier.
Thanks to Doctor Frédérique Mazodier, hand and wrist surgeon at the French Institute of Hand Surgery in Paris.