Diagnosis

Scaphoid pain due to scaphoid fractures is often not recognized because it is difficult to see on ordinary X-rays. For the reliable exclusion or diagnosis of a scaphoid fracture, CT sectional imaging is therefore used. The clinical signs are usually relatively difficult to interpret, since there is neither severe pain nor an obvious malposition.

However, the patient’s medical history, i.e. the description of the course of the accident, can provide information. If the pain on the scaphoid occurred for the first time together with a specific event, it is suspected that a fracture may have occurred. However, a permanent incorrect load, for example due to a lot of writing on the PC, can also lead to irritation or overstretching of the ligaments. In case of doubt, the CT provides clear information.

Therapy

The therapy for scaphoid pain depends on the type of injury. Scaphoid fractures are either treated conservatively with a plaster splint. However, splinting is done for 6-8 weeks, which many patients find relatively uncomfortable.

An alternative is surgical treatment using wires (“Kirschner wires”), in which the individual fracture fragments are pulled against each other, and thus heal faster under pressure. However, splinting is also necessary here, as is removal of the wires after 6 weeks. Only osteosynthesis using a plate or screw offers a faster therapy, although this is a somewhat more extensive procedure.

The plate is made of titanium and is usually left in the hand permanently. Rehabilitation can be started immediately after the operation. If there is no demonstrable fracture, the exact cause of the pain in the scaphoid must be determined.

If the cause is a one-time event, such as a fall on the ball of the hand, it is sufficient to spare the hand for some time. If a chronic process is the trigger, it is recommended to avoid corresponding movements in the future. It is possible that harmful movement patterns have already crept in, which must first be unlearned again. Medical therapy therefore goes hand in hand with physiotherapy and occupational therapy