When does surgery have to be performed?

An operation is necessary: In this case the fragments are properly assembled and fixed by certain materials. In most cases, the fixation material remains in the bone. If a conservative therapy results in incorrect healing or insufficient connection of the bone fragments (pseudarthrosis), surgery may still be necessary even after the healing process has begun.

This can prolong the healing time. However, it is important that the scaphoid heals properly in order to avoid consequential damage, especially in the wrist area. Possible consequences may include swelling:

If a comminuted fracture or fracture has occurred
In which the bone fragments have lost contact with each other
With a limited function of the wrist
In case of incongruity of the wrist

Wrist Arthrosis
Tendinitis
Tendon insertion irritation

Splint vs. plaster

The wrist should be immobilized after a scaphoid fracture. Secure immobilization is essential for fracture healing. Plaster casts and splints are suitable for this purpose.

The plaster cast is usually applied during early treatment in hospital. It cannot simply be changed, but must be reapplied each time, e.g. after washing. The handling of splints is simpler here.

There is a variety of different wrist splints, made of plastic, foam or other materials. The splints can, when correctly applied, provide very good immobilization of the bone and joints, but there is a risk of not using the splint correctly. If the splint is too loose, it may not be immobilized properly and may not heal properly. If the splint is too tight, it can affect blood and lymph flow, as well as nerve compressions and the like. This can also lead to unwanted complications such as tingling paresthesia or swelling.

How do I recognize a scaphoid fracture on my hand?

In the case of an acute injury, e.g. a fall on an outstretched hand, a fracture can result in swelling and reddening or in the formation of a hematoma (bruise). The movement of the hand is restricted and painful. The patient usually fixes the hand intuitively to the trunk to protect it from movement.

After a fall, it is also possible that the patient initially overlooks and plays down the symptoms of the fracture. Permanent pain may occur, e.g. when supporting the hand. Fracture healing is usually not possible without immobilization, and pseudarthrosis is likely to develop if the fracture is not detected.

In case of chronic pain and persistent swelling in the wrist or even in the thumb region, a physician should be consulted. The fracture can be visualized by X-ray. If necessary, a CT or MRT can be performed. Imaging is also repeated during the healing process to ensure that the fragments heal properly. Further diseases of the hand to make a differential diagnosis can be found here:

Wrist Arthrosis
Carpal fracture
Carpal tunnel syndrome
Wrist Inflammation
Tendon insertion irritation