Suspected Scaphoid Injury

Suspected Scaphoid Injury

What is a suspected scaphoid injury?

The scaphoid is a small bone in your wrist (carpus). It is the most common wrist bone to break and is usually caused by a fall onto an outstretched hand. Suspected scaphoid injury is where you have signs of a scaphoid break (fracture), but your X Rays look normal.

What are the symptoms?

You may have pain, swelling or bruising over the wrist or thumb base. It may hurt to move your wrist.

How are suspected scaphoid injuries managed?

Most suspected scaphoid injuries are not actually caused by scaphoid breaks or fractures. There can be other injuries causing the symptoms, such as a sprain (ligament injury) or bone bruising. Occasionally, the symptoms can be caused by an occult (invisible on X-ray) fracture or break, either to the scaphoid or another nearby bone.  Most of these stable injuries will settle with time, usually by around 6 weeks.

Scaphoid fractures have a small risk of not healing (non-union). One person in 300-500 who presents with a suspected scaphoid injury will develop a scaphoid non-union. This risk is increased if the wrist is not immobilised. For this reason, it is recommended to splint this injury until your pain settles or such time that ongoing splinting does not influence outcome (usually by around 6 weeks).

What should I expect from my wrist injury?

Most of the time, injuries to the wrist follow this pattern:

• By 2 weeks: you may still have swelling but should feel comfortable in your splint
• By 4 weeks: the swelling should have gone down and you should only need your splint for heavier activity
• By 6 weeks: you should be doing your normal activities and the wrist should be able to move fully. You should feel able to perform a push up.

If the symptoms do not follow this pattern, then usually a repeat clinical examination with further X-rays or a scan is recommended.

The following checklist may help you to decide if you need our help:

• Week 2       I am comfortable in my splint
• Week 4       I am able to do most activities in my splint
• Week 6       I am pain free and able to function normally without my splint. I have full movement and could perform a press up without pain.

If you are unable to check off any of the boxes, please contact the Virtual Fracture Clinic to discuss with our team.

What should I try to do with my wrist?

You should try to start moving the fingers as soon as possible after the injury, whilst wearing your splint.
After 2 weeks, you should try to take off splint and begin gentle movements. If this is too painful, replace the splint for another two weeks, then retry movements at that point.
By 6 weeks, you should be able to return to manual work.

If you remain unable to do a press-up or you feel that the wrist remains stiff, even if your pain has settled, then please contact the Fracture Clinic for a further review:

Fracture Clinic Contact Details:
Fracture Clinic, Larkspur Suite
Worcestershire Royal Hospital
Charles Hastings Way
Worcester 
WR5 1DD
Tel:                  01905 760259
Email:              wah-tr.virtualfractureclinicwrh@nhs.net
Working Hours:       0700 – 1500, Monday – Friday

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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