Why a scaphoid fracture (wrist injury) can impact return to play
Wrist injuries are common among young athletes. A fall onto an outstretched hand is a common mechanism of injury. The most commonly fractured bone around the wrist with such a mechanism is the radius bone, accounting for roughly one third to one half of all wrist fractures in children. Though less common overall, another important fracture from a fall onto an outstretched hand is the scaphoid fracture. The scaphoid bone, a small bone that sits on the thumb side of the wrist, is the most commonly fractured carpal bone. A scaphoid fracture is difficult to diagnose as it is often not seen on initial X-Rays. It can be devastating if not treated properly and can ultimately impact return to play.
Some of the symptoms include pain and swelling at the base of the thumb and increased pain with movement and gripping objects. If you think your child has a wrist injury, it’s always best to have an examination by a physician to determine the need for diagnostic imaging and treatment. Some of the diagnostic tests may include:
- X-ray: the most common diagnostic test for a scaphoid fracture. This test utilizes electromagnetic waves of high energy to distinguish bone from soft tissues (muscles, tendons, ligaments, skin, fat tissue). This test is commonly used as an initial test to determine if your child has sustained a scaphoid fracture.
- Magnetic Resonance Imaging (MRI): a radiation-free test that uses large magnets to produce detailed images of both soft tissues and bone. MRI is best for determining pathology of tendons and ligaments that cannot be seen with X-Rays alone. An MRI may pick up a scaphoid fracture that a plain film X-ray misses.
- Computerized Tomography (CT or CAT scan): uses X-Rays to produce ‘virtual’ slices of body parts. CT’s are particularly important for looking at bones. They produce images that are more detailed than typical X-Rays.
Once the diagnosis of the scaphoid fracture is made, your doctor will determine the best possible treatment plan. The non-surgical approach involves a cast that includes the thumb. Healing time is usually 4 to 6 weeks in these instances.
If the fracture involves two separate pieces of the scaphoid bone, surgery may be needed. Compression screws, wires and implants are some of the surgical techniques used to hold the bone together. Recovery time can vary.
At Cincinnati Children’s, we have a team of physical therapists with pediatric training to assist your child with his or her wrist rehabilitation. Your child’s therapist will work individually with your child to design a regimen aimed at restoring function.
For more information, contact the Pediatric Sports Medicine experts and make a same day appointment by calling 513-803-HURT.