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In brief
A dull, deep pain in the wrist after a fall on an outstretched hand is the hallmark of a scaphoid fracture. Pain with maneuvers that stress the scaphoid can suggest fracture on physical exam. Radiographs are crucial: Determining the location, stability, and orientation of the fracture guides treatment and predicts outcome. Distal fractures and horizontally oriented fractures generally heal well and can be managed by immobilization in a shortarm thumb spica cast. Proximal fractures and vertically oriented fractures have the most morbidity, and open reduction should be considered. When prolonged immobilization is required, range-of-motion and strengthening exercises are prescribed to restore hand function after cast removal.
Additional information
Notes on contributors
Greg Gutierrez
Dr Gutierrez is in private practice at The Denver Center for Sports and Family Medicine in Denver. He is director of sports medicine education for the St Joseph Hospital family practice residency and is a clinical instructor at the University of Colorado Health Sciences Center, both in Denver. He is a member of the American Medical Society for Sports Medicine and holds a certificate of added qualification in sports medicine.