What is a Navicluar or Scaphoid Fracture?

Your wrist is made up of eight bones that attach to the bones in the hand. One of the wrist bones near your thumb has two different names: it is called the scaphoid bone or navicular bone. A fracture is a break through a bone. Because this wrist bone does not have a good blood supply, fractures to this bone sometimes have a healing problem.

How does this occur?

A navicular fracture is caused by a fall or a direct blow.

What are the symptoms?

You have pain and swelling in your wrist, usually just below the thumb. If you hold your hand in the "hitchhiking position," the thumb tendons are visible on the back of your hand. The tendons make an area called the "snuff box." When the navicular bone is fractured, there will be tenderness in the "snuff box."

How is it diagnosed?

Your doctor will examine your wrist and review your symptoms. An x-ray will be ordered and may show a break in the navicular bone. Sometimes a fracture may not show up in the first x-ray and your doctor may recommend that you have a repeat x-ray in 1 to 2 weeks.

How is it treated?

You will need to wear an arm cast that will include your thumb. The cast may or may not extend above your elbow and may be left in place for up to 12 weeks to be sure the bone heals. In some cases healing does not occur and the pieces of bone do not grow back together. This may require surgery to fix.

Sometimes the failure of the pieces of bone to grow back together leads to a problem called avascular necrosis, part of the bone dies because it does not get enough blood. In these cases, an operation is necessary to remove part of the injured bone, insert bone to help heal the fragment, or insert an artifical bone. Complete recovery may occur or you may have some permanent stiffness or loss of range of motion.