The treatment your doctor recommends will depend on a number of factors, including:
Fracture near the thumb. Scaphoid fractures that are closer to the thumb (distal pole) usually heal in a matter of weeks with proper protection and restricted activity. This part of the scaphoid bone has a good blood supply, which is necessary for healing.
For this type of fracture, your doctor may place your forearm and hand in a cast or a splint. The cast or splint will usually be below the elbow and include your thumb.
Healing time varies from patient to patient. Your doctor will monitor your healing with periodic x-rays or other imaging studies.
Fracture near the forearm. If the scaphoid is broken in the middle of the bone (waist) or closer to the forearm (proximal pole), healing can be more difficult. These areas of the scaphoid do not have a very good blood supply.
If your doctor treats this type of fracture with a cast, the cast may include the thumb and extend above the elbow to help stabilize the fracture
Bone stimulator. In some cases, your doctor may recommend the use of a bone stimulator to assist in fracture healing. This small device delivers low-intensity ultrasonic or pulsed electromagnetic waves that stimulate healing.
If your scaphoid is broken at the waist or proximal pole or if pieces of bone are displaced, your doctor may recommend surgery. The goal of surgery is to realign and stabilize the fracture, giving it a better chance to heal.
Reduction. During this procedure, your doctor will administer an anesthetic or anesthesia and manipulate the bone back into its proper position. In some cases, this is done using a limited incision and special guided instruments. In other cases, it is performed through an open incision with direct manipulation of the fracture. For some fractures, your doctor may use a tiny camera called an “arthroscope” to aid in the reduction.
Internal fixation. During this procedure, metal implants—including screws and/or wires—are used to hold the scaphoid in place until the bone is fully healed.
The location and size of the surgical incision depends on what part of the scaphoid is broken. Sometimes, the screw or wire can be placed in bone fragments with a small incision. In other cases, a larger incision is needed to ensure that the fragments of the scaphoid line up properly. The incision may be made on either the front or the back of your wrist.
Bone graft. In some cases, a bone graft may be used with or without internal fixation. A bone graft is new bone that is placed around the broken bone. It can stimulate bone production and healing. The graft may be taken from your forearm bone in the same arm or from your hip.