Wrist pain after a fall - Scaphoid Fracture

If you have fallen onto an outstretched hand and now have a deep ache on the thumb side of your wrist, especially when gripping or twisting, you may have injured one of the small bones in your wrist.

What is it?

The scaphoid is a small, boat-shaped bone on the thumb side of the wrist, sitting between the bones of the forearm and the bones of the thumb. A scaphoid fracture is a break in this bone. It is one of the most commonly fractured wrist bones, but because of its size, shape and position, it can be surprisingly easy to miss on an early X-ray.

Why does it happen?

Most scaphoid fractures happen after a fall onto an outstretched hand – sometimes called a “FOOSH” injury – such as tripping on a pavement, falling from a bike, or landing awkwardly during sport. The force travels up through the palm and concentrates on the scaphoid, which can crack under the strain. The scaphoid has a more limited blood supply than many other bones, which is part of why fractures here are taken seriously and monitored carefully as they heal.

When should I see a hand surgeon?

If, after a fall, you have pain, swelling or tenderness in the hollow just below the base of your thumb – particularly if it is worse when you grip, push up from a chair, or twist your wrist – it is worth being assessed promptly, even if an X-ray taken straight away looks normal. Scaphoid fractures are notoriously difficult to see on early imaging, so ongoing pain after a fall, on its own, can be a good enough reason to seek a further opinion and additional scans such as an MRI or CT. Catching this injury early makes a real difference to how well it heals.

How is it treated?

Many scaphoid fractures heal well with a period in a cast or splint, particularly when the broken pieces of bone are well aligned and stable. Other fractures – for example those that are displaced, unstable, or affect certain parts of the bone – are often better treated with a small operation to fix the bone with a screw, which can also support a quicker return to normal activities. The right choice depends on the exact pattern of your fracture, your lifestyle and how quickly you need to get back to work, sport or daily tasks, so an individual assessment is important.

If you have hurt your wrist in a fall and the pain is not settling, book a consultation at londonhandandwristsurgeon.com for an individual assessment.