Why Scaphoid Fractures Get Missed – Warning Signs You Should Never Ignore: By Dr. Balaraju Naidu, Robotic Orthopedic Surgeon, ONUS Robotic Hospitals
Scaphoid fractures are one of the most commonly overlooked injuries, especially after a fall on an outstretched hand. Unlike typical fractures, scaphoid injuries don’t always present with severe pain or swelling. This makes them easy to miss — both by patients and sometimes even by initial medical screening.
At ONUS Robotic Hospitals, we frequently see patients who come weeks or months later with persistent wrist pain, only to discover a scaphoid fracture that was missed earlier.
Why Are Scaphoid Fractures Missed?
1. X-rays Often Appear Normal Early
In the first 24–72 hours, the fracture line may not be visible on a standard X-ray. Up to 25–30% of scaphoid fractures are missed initially. This is because the bone is small, irregular, and deep within the wrist.
2. Mild Pain Misleads Patients
Scaphoid pain is dull and subtle, unlike the sharp pain of typical fractures. Many patients mistake it for a simple wrist sprain and continue regular activities.
3. Minimal Swelling
Since the scaphoid has limited soft tissue around it, swelling is either absent or minimal. This leads both patients and general physicians to underestimate the injury.
4. Poor Blood Supply Complicates Healing
The scaphoid receives blood from one side only, making it vulnerable. Even a small undiagnosed fracture can progress to avascular necrosis if neglected.
5. Inadequate Physical Examination
A crucial indicator of scaphoid fracture is tenderness in the anatomical snuffbox. If this is not checked properly, the diagnosis can be missed.
What Happens When a Scaphoid Fracture Is Missed?
1. Non-Union
The bone fails to heal, leading to chronic pain.
2. Avascular Necrosis (AVN)
The top portion of the bone may die due to limited blood supply.
3. SNAC Wrist (Scaphoid Non-union Advanced Collapse)
A severe condition where wrist bones collapse, leading to arthritis.
4. Restricted Wrist Movements
Patients lose grip strength, flexibility, and experience long-term stiffness.
Symptoms You Should Watch Out For
- Pain at the base of the thumb
- Pain when holding objects
- Pain during push-ups or lifting
- Tenderness in the snuffbox (between thumb tendons)
- Pain increases when bending the wrist backward
If any of these signs appear after a fall, assume it could be a scaphoid fracture and get evaluated.
Accurate Diagnosis at ONUS Robotic Hospitals
Our specialists use:
✔ Special scaphoid view X-rays
✔ CT scans for fracture detail
✔ MRI for early detection
✔ Ultrasound-guided assessment
✔ Clinical orthopaedic evaluation
Treatment
Non-Surgical
- Thumb spica cast for 6–12 weeks
- Immobilization
- Regular follow-ups with X-rays/CT
Surgical
- Headless compression screw fixation
- Bone grafting for non-union
- Minimally invasive techniques
Early diagnosis ensures 95% healing, while delays increase complications drastically.
Scaphoid fractures are silent but dangerous. Ignoring persistent wrist pain after a fall can lead to lifelong wrist dysfunction. ONUS Robotic Hospitals provides advanced diagnostics and treatment options to ensure rapid recovery and long-term wrist health.
For Appointments:
ONUS Robotic Hospitals – Hyderabad
