Wrist Pain; Scaphoid or Navicular Fracture
Scaphoid fracture one of the most common fractures at the wrist. It has been observed that generally there is a history of fall on outstretched hand. It has also been established that male are at higher risk and generally in people between the ages of 10-19 years. Scaphoid bone fracture is of significance because it can be missed on normal X-rays and at times quite difficult to diagnose. To avoid the complications, correct diagnosis and timely treatment is vital as 90% heal if treated promptly.
Scaphoid fracture, if ignored can lead to adversities like;
· Nonunion of the bone.
· Delayed union of the bone.
· Bone necrosis (death of bone tissue).
· Decreased grip strength.
· Decreased range of motion.
· Osteoarthritis of the wrist joints.
Scaphoid or navicular bone is largest of the 8 small bones that make up the wrist. It is boat shaped bone, at the base of the thumb almost an inch long. It is present below the anatomic snuffbox (a triangular depression seen at the base of thumb, on the outer side of the hand when thumb is fully extended). Scaphoid bone has a significant role in stability and also in normal wrist’s full range motion. The bone has a scanty blood supply, which is the main reason of adverse outcomes like delayed union, nonunion or necrosis. Most of the bone is covered with cartilage and after the Scaphoid fracture the wear and tear of cartilage becomes the reason of arthritis.
Scaphoid or navicular fracture happens when the Scaphoid bone gets compressed against the forearm bone. Scaphoid fracture can be classified in many ways, like by;
· Site or location.
· Plane; vertical or horizontal.
· According to time of injury;
o Acute
o Occult
· Stability of the bone
o Non displaced/stable (bone is cracked but is still perfectly lined up)
o Displaced/ unstable
These classifications help in deciding the course of treatment.
The patients usually come with wrist pain complaint which is deep set and dull. A pain, that increases on squeezing or gripping objects or action. The anatomical snuffbox might have swelling and seems padded. There might be some bruising or swelling at the wrist joint. There are number of cases with mild symptoms, so they assume it to be a wrist sprain only and try to deal with it, themselves.
A careful history and methodical physical examination of the hand will show positive ‘Scaphoid Compression Test’ (anatomic snuff box will be highly tender when compressed) in this fracture. X-ray might miss the fracture imaging due to positioning of the bone or in some in early cases. In every 10 case 1-2 are missed on X-ray than CT and MRI scan are ordered.
While treating Scaphoid fracture all its classifications are considered; severity, time, plane, and stability. The rule of the thumb followed is; clinically positive but X-ray is negative, PRICE (Protection, Rest, Ice, Compression, and Elevation) and put a cast then repeat radiograph after 2 weeks and re-evaluate. Non- displaced, that has good blood supply is put in the cast including the thumb, wrist, forearm and elbow as well. Surgery is the option for rest of them and surgery complication can be infection, nerve injury, stiffness or bone healing failure.
Houston! If you or anyone you know has wrist pain and think it is ‘Scaphoid or Navicular fracture’, come to ‘Walk in Chiropractic Associates’. Have it checked in a comfortable and friendly environment by our proficient and skilled team of chiropractors. We have helped many people who came with wrist pain and best thing is, with noninvasive and drug free methods.
Call Ph # (713) 529-4808 for further information and to make an appointment. You can check reviews of our patients how they were relived, and how our plan gave them ways to avoid future problems and return to their active routines to enjoy life. We are located at 2002 Binz Street, suite B, Houston, TX 77004
