What Treatment Is Available for Scaphoid Fractures?

After receiving a scaphoid fracture diagnosis, the subsequent treatment will depend on a few factors:

• Fractured bone alignment – whether the scaphoid is shifted or in its proper position, the fracture may be displaced or non-displaced.
• Injury-to-treatment time – the likelihood of nonunion increases as time goes on and the fracture isn't addressed.
• Location – non-union is more common in the end closest to the thumb, known as the proximal pole. 

Non-Surgical Approach

When the scaphoid fracture maintains its natural alignment (i.e., non-displaced), non-surgical treatment options are available to address the injury. The casting of the wrist and thumb is usually employed to immobilize the wrist while the fracture heals. 

In the first few weeks, the cast may be positioned above the elbow and reduced in length progressively. If this approach doesn't yield results in the first 6 weeks, an electromagnetic stimulator may be used to encourage bone growth. 

This method can last between 6 to 12 weeks, and the cast can be removed if the fracture has healed. The next step is surgical intervention if the fracture is not healing following cast immobilization.

Surgical Approach

The risk of nonunion increases with scaphoid fractures that don't heal following cast immobilization. If this happens, surgery is recommended to reposition the bones and maintain their proper alignment. 

Screws are typically used to realign the broken scaphoid bones and maintain their appropriate position, followed by 8 to 12 weeks of casting. If the fracture remains unresponsive, bone grafting may be required to stimulate bone growth and healing. 

Athletes can opt for surgery as an initial treatment even in the case of a non-displaced fracture. This approach reduces the risk of nonunion and immobilization through casting is significantly mitigated, allowing for a quicker recovery and return to sport.