Scaphoid Fracture

Your Child's Diagnosis

The scaphoid is a small bone in the wrist. Children may break the scaphoid when they hold out their hand to stop a fall. Health care providers are very careful with the scaphoid bone because sometimes it has trouble healing.

When a child has wrist pain after a fall, it is necessary to use X-rays to look for a fracture. Sometimes a fracture of the scaphoid is hard to see on regular X-rays because of the bone's shape, and a visit to an orthopedic doctor (bone specialist) or special test is needed.

The health care provider carefully examined your child. Either your child's X-rays showed a fracture in the scaphoid bone or there is pain near the scaphoid bone and the health care provider thinks a fracture is possible.

Health care providers treat scaphoid fractures with a splint or cast. A splint is like a cast and gives support to the hand, but is soft part of the way around to allow room for swelling.

• If a splint is used, it will be changed to a full cast after a few days.
• If a cast was placed today, it will be worn for 1–5 months.

Some fractures that do not heal well on their own may need surgery to bring the broken pieces of bone together, but this is rare.

Home Care Instructions

• Leave the splint or cast in place until it is removed by your health care provider.
• Give your child pain medication as directed.
• For swelling and pain in the first 24–48 hours after the injury:
  • Use pillows to raise the wrist above the level of your child's heart.
  • Apply cold packs wrapped in a towel to the cast or splint for 20–30 minutes every 3–4 hours.
• Do not get the splint or cast wet. Your child should bathe instead of shower. Use a plastic covering over the splint or cast as directed while bathing and keep it completely out of the water.
• Do not put anything (including objects, fingers, lotions, or powders) inside the splint or cast.
• For itching, use a cool hair dryer to blow air in and around the edges of the splint or cast.
• Encourage your child to wiggle his or her fingers to keep blood circulating normally.

Special Instructions

• Follow up with the orthopedic doctor as recommended.
• Follow the instructions about when your child can return to sports and other activities.

Call Your Healthcare Provider if...

• Your child gets a fever without a clear reason.
• Your child's pain isn't relieved by pain medication or gets worse.
• There are blisters, rashes, or raw spots on the skin around the splint or cast.
• A foul smell or discharge comes from the splint or cast.

Go to the ER if...

• Your child's fingers turn numb, tingly, pale, or blue.
• The splint or cast feels too tight.
• The splint or cast gets wet, cracks, breaks, or falls off.

Other Things to Think About

Once the cast or splint is removed, your health care provider may recommend physical therapy to help increase strength and lessen stiffness of the wrist. Also, your child might need to wear a brace or splint during sports and activities to protect the wrist for a few months.