Let’s go through your injury and what to expect during recovery.

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You’ve injured a small but important bone in your wrist, called the scaphoid. It sits near the base of the thumb and plays a key role in wrist stability and movement.

 

One of the tricky things about scaphoid fractures is that they don’t always show up clearly on the first X-ray. If your symptoms suggest a scaphoid injury, we often treat it as a fracture right away, even if the initial scan looks normal. That usually means putting your wrist in a cast or splint and arranging follow-up in the fracture clinic.

 

At your clinic appointment, one of the orthopaedic specialists will reassess your wrist. Sometimes the cast will be removed briefly to examine the area more closely. In some cases, we’ll confirm the diagnosis of a fracture. In others, we may be confident that there isn’t a fracture and discharge you. If there’s still uncertainty, we may organise an MRI scan. This is more sensitive than X-ray and can detect small or subtle fractures that don’t appear on plain films.

 

Scaphoid fractures need careful management because certain parts of the bone have a poor blood supply, which can slow down healing or make it less reliable than in other bones.

 

How we treat the fracture depends on a few key things — where the break is, whether the bone fragments are out of position, and your age and activity level.

 

Many scaphoid fractures can be treated with immobilisation alone, especially when the break is near the middle or outer end of the bone and the fragments haven’t moved. In these cases, we’ll usually put your wrist in a below-elbow cast, which is worn for around eight weeks. That’s longer than with most fractures, because the scaphoid heals more slowly due to its limited blood supply.

 

During this period, we’ll arrange follow-up to check that healing is progressing as expected. It’s important to avoid stressing the wrist while it heals — that means no lifting, pushing, pulling, or weight-bearing through that hand.

If the fracture is displaced, or if it involves the part of the scaphoid with the poorest blood supply, we may recommend surgery. This involves a small incision to realign the bone fragments and hold them in place with a screw. It’s usually done as a day-case operation.

 

The most important risk with a scaphoid fracture is non-union — where the bone doesn’t heal properly. Because of the poor blood flow in parts of the scaphoid, this is a real concern. To help the bone heal, it’s important to avoid anything that could reduce blood supply — for example, smoking or using nicotine vapes. If the fracture fails to heal, it can lead to long-term problems like chronic wrist pain, reduced movement, and eventually arthritis in the wrist. That’s why early diagnosis and proper treatment are so important.

 

Sometimes, we still don’t see a fracture on X-rays or even on MRI, but your symptoms are convincing. In those cases, we take a cautious approach — we keep the wrist protected and reassess after a short period. If we remain confident that no fracture is present, we can safely remove the cast and discharge you.

 

Most scaphoid fractures heal well with the right treatment. Around 5 to 10% of patients may experience delayed or non-union. Most patients are in a cast for eight weeks, though in some cases, we may recommend a bit longer in a cast or splint if healing is slower than expected.

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Once you’ve completed your period of immobilisation and things look like they’re healing, we’ll usually discharge you from clinic and refer you to the hand therapy team. These are specialist physiotherapists who help you regain strength, flexibility and confidence in your wrist after time in a cast.

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It’s completely normal for the wrist to feel stiff, sore or weak after being immobilised. Hand therapy will guide you through rehab exercises to improve your movement and function.

 

You’ll be encouraged to start gently using the wrist again for light activities — things like typing, writing, or lifting light objects. But high-impact activities, sports, or manual work should be avoided until your wrist has regained full strength and comfort.

 

If you’ve had surgery, the recovery is broadly similar — but the fixation may make the wrist stable enough to allow earlier movement. Your surgeon will guide the exact timing of your rehab, based on what was found and done during your operation.