Scaphoid Fracture Fixation

Through a small incision, the fractured scaphoid is realigned and secured, typically with a single screw placed down the length of the bone to compress the fracture and support healing. The procedure typically takes one to two hours and is usually day surgery.

Assessment includes examination and X-rays, sometimes supplemented with a CT or MRI scan if the fracture is subtle or not clearly visible on the initial X-ray. Standard preoperative steps apply, including fasting and arranging transport home.

A splint or cast supports the wrist initially, with hand therapy introduced as the surgeon confirms healing is progressing on follow-up X-rays. Healing can take longer than other wrist fractures given the scaphoid's limited blood supply, often several months.

Rehabilitation begins with protected movement of the fingers and thumb while the wrist itself is immobilised, progressing to wrist movement and strengthening once healing is confirmed on imaging, guided by the surgeon and hand therapist.

Risks include infection, and, specific to this fracture, delayed healing or nonunion, where the bone fails to fully heal, given the scaphoid's limited blood supply. This risk is higher with delayed diagnosis or treatment, which is one reason prompt fixation is often recommended.

The aim is reliable healing of a bone that is prone to slow or incomplete healing if not properly stabilised, given its limited blood supply. Most patients achieve good healing and a return to normal wrist function, particularly when the fracture is treated promptly.

Scaphoid fracture fixation stabilises this important wrist bone with a screw, aiming to give it the best chance of reliable healing given its limited blood supply. Most patients heal well with timely, appropriate treatment.

For a general guide to what to expect during recovery from a hand or wrist fracture, see what to expect after a hand or wrist fracture.