Overview
A scaphoid fracture is a break in one of the small wrist bones called the scaphoid, located near the thumb on the thumb-side of the wrist. Because the scaphoid has a limited blood supply, some fracture patterns can heal slowly and may develop nonunion or bone tissue death (avascular necrosis). When the injury is missed early, the wrist can become stiff and gripping strength can decline. With prompt diagnosis and proper immobilization, many scaphoid fractures heal well without surgery.
Symptoms
Pain is usually felt on the thumb side of the wrist, often with tenderness in the anatomic snuffbox or when pressing over the scaphoid. Swelling and bruising may occur, though they can be mild. Pain often worsens with wrist motion, gripping, or lifting, and some people notice reduced grip strength. In some cases-especially early on-there may be no obvious deformity, making the injury easy to underestimate.
Causes
Scaphoid fractures most commonly happen after a fall onto an outstretched hand (FOOSH), where the scaphoid absorbs the impact and twisting forces. Direct blows to the wrist can also cause the fracture. Depending on where the break occurs, some scaphoid segments have a higher risk of poor blood supply and delayed healing.
Risk Factors
Risk increases with activities or situations that involve falls onto the hand, such as sports, cycling, skiing, and ladders or stairs. Smoking and nicotine exposure can impair bone healing. People who have had a prior scaphoid injury or delayed treatment for wrist trauma may be at higher risk for complications like prolonged healing and nonunion.
Prevention
To reduce risk, practice fall-prevention techniques and use appropriate protective gear for activities with high fall risk. When using ladders or working at height, improve stability and avoid rushed steps that can lead to FOOSH injuries. If you have wrist pain after a fall, getting evaluated promptly and keeping the wrist immobilized as advised can help prevent missed fractures and delayed healing.
How the Diagnosis Is Evaluated
Clinicians start with a detailed history of the fall or injury and an exam focused on thumb-side wrist tenderness, especially in the anatomic snuffbox. Specific provocative tests may be used to check scaphoid tenderness and pain with wrist or thumb movement. X-rays are usually the first imaging test, but early fractures can be hard to see. If suspicion remains high despite negative or unclear X-rays, MRI or CT is commonly used to confirm the diagnosis and guide treatment.
Nonsurgical Treatment Options
The main non-surgical treatment is immobilization with a thumb spica splint or cast to allow the scaphoid to heal, typically followed by scheduled follow-up imaging. Pain control often includes short-term use of acetaminophen and/or anti-inflammatory medications if safe for you. Keeping the wrist protected from lifting, gripping, and twisting reduces stress on the healing bone. A gradual return to motion and strengthening is usually started only after the clinician confirms healing or adequate stability. If pain persists or imaging shows delayed healing, the immobilization plan may be adjusted and additional imaging may be ordered.
When to Seek Medical Attention
Seek prompt medical attention after a fall onto an outstretched hand if you have thumb-side wrist pain, snuffbox tenderness, or trouble using your grip. Get urgent care sooner if you cannot move the wrist or thumb, have rapidly increasing swelling, severe pain that is not improving, or numbness and tingling in the hand. Fever, spreading redness, or feeling unwell with wrist pain are also reasons to be evaluated urgently. If you were told imaging was normal but your symptoms persist, you should follow up because scaphoid fractures can be missed early.
Frequently Asked Questions
It often causes pain and tenderness on the thumb side of the wrist, especially in the anatomic snuffbox, and pain with gripping or wrist motion.
Healing time varies by fracture location and stability, but it often takes several weeks to months, which is why follow-up imaging is important.
Next Steps
If you have thumb-side wrist pain after a fall, consider getting evaluated soon and ask whether scaphoid fracture is a concern. Until you are assessed, avoid heavy lifting or twisting and consider keeping the wrist immobilized if advised. Follow up with your clinician if pain persists or if initial X-rays were negative but your symptoms fit a scaphoid fracture.