Florida personal injury lawyer, Guy S. DiMartino, DC, JD discusses the perils of a scaphoid fracture in the wrist.
The scaphoid bone also known as the carpal navicular bone is the most commonly broken bone in the wrist. It is located at the base of the thumb. The bone gets its name because it is boat shaped. The shape of the bone and its poor blood supply make this a serious injury with the potential for poor healing and longstanding problems.
Types of accidents in which I have seen scaphoid fractures
In my personal injury practice, I have seen scaphoid in two main types of accidents. I have seen 3 or 4 in falls. I remember one in a client that fell over a parking bumper and landed on her outstretched arm. I remember another scaphoid fracture that happened to a client who was involved in a front end crash and his hand and wrist were jammed up against the steering column.
Physical examination findings in a scaphoid fracture
The hallmark sign is tenderness in the anatomical snuff box. If you want to find your anatomical snuff box – extend your thumb, and follow it down the wrist – at the base of the thumb there will be a little box that you can fill with snuff. The scaphoid bone is the floor of the anatomical snuff box.
Diagnostic imaging of a scaphoid fracture
Plain film x-ray can show a scaphoid fracture. The x-ray attached above shows a fracture of the scaphoid. Sometimes MRI will pick up a scaphoid fracture. Other tests like bone scintigraphy (bone scan) can find occult or difficult to diagnose fractures.
Treatment of non-displaced scaphoid fractures
If the fracture is non-displaced, that means the bones have not separated, the standard treatment includes immobilization and casting of the wrist. Non-displaced fractures heal relatively well. Non-displaced fractures, on the other hand, STINK.
Non-displaced scaphoid fractures
Non-displaced fractures have a high degree of non-union and subsequent avascular necrosis of the bone. These fractures require hardware to approximate the bone. Typically, screws and/or wires will be used to bring the pieces of bone closer together to allow healing.
Complications of scaphoid fracture
Folks can develop a number of complications after scaphoid fractures. If the person works with their hands, their livelihood can be devastated. Below are some of the recognized complications associated with a scaphoid fracture:
Non-union happens when the bone refuses to heal. It usually happens because the blood supply to the scaphoid is pretty bad. Without good blood supply, the body cannot bring needed nutrients for healing and repair and the body cannot take away the waste products associated with healing. A number of folks who develop non-union will have to undergo bone grafting.
Avascular necrosis is death of the bone because the blood supply is disrupted. If the blood supply is disrupted – the bone will not get the proper nutrients and will die. Avascular necrosis can be treated with a bone graft that still has its blood supply attached; however, it is not the most successful surgery.
Post traumatic arthritis : if the bone does not fuse – the area becomes unstable. The body attempts to stabilize the area by putting down calcium, which becomes arthritis.
Compensation for this Injury
If you fractured your scaphoid because of an accident caused by another person's negligence whether it be a slip and fall or car accident, you will need an attorney that has the medical knowledge to understand how the future with this type of injury will play out. A scaphoid fracture is not just another broken bone that will heal; many times people have significant impairment and disability for the rest of their lives. If you have any questions about a scaphoid fracture injury, give me a call at (352) 267-9168 or fill out the internet consultation form on the right hand side of the screen.