Pathophysiology

The scaphoid is one of the small carpal bones located in the first row of carpal bones, on the thumb side of the hand. This can be triggered by trauma e.g. falling onto an outstretched hand or a direct blow. Occasionally stress fractures can occur but these are generally in high level athletes e.g. gymnasts and shot-putters.

Symptoms

• Specific pain over the scaphoid near the base of the thumb
• May have swelling or bruising

Management

• Activity modification
• Ice or heat
• Pain relief
• Physiotherapy including range of movement, strengthening exercises and splinting
• Orthopaedic options include immobilisation and surgery

Investigations

• X-ray to identify fracture will often not be seen straight away after trauma
• If scaphoid fracture is suspected further imaging may be done such as CT and MRI scans