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What is it?

The scaphoid bone is one of the carpal bones in the hand. It is in the thumb area and is the first bone of the first row of the carpus. The scaphoid is one of the bones that is injured the most.

What is its function?

The carpal bones are a unit that provide bony structure to the hand. Along with the lunate, it articulates with the radius and ulna to form the main bones involved in wrist movement. The scaphoid is a link between the two carpal bone rows.

Scaphoid bone injuries

A hand scaphoid fracture is one of the most common injuries, due to its proximity to the two rows of carpal bones. Fractures tend to happen due to falling on an extended hand or due to a bad stretch. Pain and wrist swelling are the most common symptoms. Any pressure on the bone can cause intense pain. Sometime a scaphoid fracture only causes mild discomfort and pain in the area. A scaphoid fracture can be difficult to diagnose as it is often confused with a wrist sprain.

Another condition that affects the scaphoid is scapholunate instability, which occurs when the scapholunate ligament (that connects the scaphoid with the lunate bone) and other surrounding ligaments rupture. When this happens, the gap between the scaphoid and the lunate bones increases.

Preiser disease is a rare condition which is also known as idiopathic avascular necrosis of the scaphoid. It causes bone ischemia and necrosis without a previous fracture.

What are the treatments?

Treatment for a scaphoid bone fracture involves putting a cast on the hand to immobilise the wrist, although in some cases, surgery may be resorted to. Treatment for scapholunate instability can be treated by following the following guidelines:

• Apply ice regularly.
• Immobilise the area.
• Raise the arm to prevent oedema.
• Contrast baths (hot and cold water).
• Active and passive wrist movements.
• Proprioception.
• Strengthen muscle.
• Using Kinesio tape bandage.

If carpal instability is due to an architectural bone alteration, the bone defect should be corrected by osteotomies, bone wedge grafts, or osteosynthesis. Severe joint degeneration can be caused by wrist instabilities, which can be radiocarpal or midcarpal, and normally requires a more radical treatment. Treatment for Preiser disease is normally conservative treatment, which involves immobilisation using a cast. Surgery may also be resorted to.

What specialist should I see?

An orthopaedic surgeon is the specialist who prevents, diagnoses, and treats musculoskeletal conditions and injuries. An orthopaedic surgeon aims to treat muscle, joint, and ligament injuries and fractures either surgically or orthopaedically.