The scaphoid is a small bone in the wrist. After fracture the bone is at risk of not healing.
Pain on the thumb side of the wrist after an injury is a warning sign. Most scaphoid fractures can be seen on a good X-ray. Subtle fractures may need further tests such as an MRI scan to be diagnosed.
The risk of not healing is greater if there is shift or displacement of the fracture. If a fracture is not protected in a cast, or is in the part of the bone called the proximal pole, it is also at greater risk of not healing.
A scaphoid nonunion is a fracture that has not healed, and often stays sore, can cause weakness of the wrist, and can eventually end in arthritis of the wrist.
Low risk fractures can be treated in a cast, but scaphoid fractures take up to 3 months to heal.
Fractures that are judged to be at higher risk of not healing are best treated with surgery. The fracture is reduced or put back in its normal shape, and then fixed with a special screw.