Scaphoid fracture surgery repairs a broken scaphoid, one of the small carpal bones in the wrist, located on the thumb side near the base of the thumb. The surgery is known as open reduction and internal fixation, or ORIF, which means the surgeon realigns the broken bone and holds it in place with a small screw or pin so it can heal. Surgery is not needed for every scaphoid fracture, but for certain breaks it can give the bone a better chance to heal fully.

If you have broken your scaphoid, understanding when surgery helps can make the decision easier. The board-certified and fellowship-trained hand and wrist specialists at Resurgens Orthopaedics perform scaphoid fracture surgery at locations across metro Atlanta and guide patients through recovery.

What You Need To Know About a Scaphoid Fracture ORIF

• Why Scaphoid Fracture Surgery Is Performed
• When Surgery Is Recommended
• What Happens During Scaphoid Fracture Surgery
• Recovery After Scaphoid Fracture Surgery
• Risks of Scaphoid Fracture Surgery

Why Scaphoid Fracture Surgery Is Performed

The scaphoid has a limited blood supply, especially in the part closer to the forearm, which is what makes some of these fractures slow or difficult to heal. Surgery is performed to bring the broken pieces back into position and hold them securely, giving the bone the stability and contact it needs to knit together. By stabilizing the fracture, ORIF is designed to lower the risk of two long-term problems that can follow an untreated or poorly healed scaphoid fracture: a fracture that never fully heals and wrist arthritis.

When Surgery Is Recommended

Many scaphoid fractures, especially nondisplaced breaks near the thumb, heal well in a cast. Your physician may recommend surgery instead when:

• Displaced Fracture: The pieces have shifted out of position
• Break Near the Forearm: The fracture is at the waist or proximal pole, where the blood supply is poorest
• Fracture Not Healing: The bone has not healed after a period of casting
• High Activity Demands: Your sports or work place heavy demands on the wrist, which your physician will factor into the decision

Please Note: The decision between casting and surgery depends on the location of the break, whether it has shifted and your activity level. Your physician will walk you through which approach gives your wrist the best chance to heal fully. To learn more about the injury itself, see our scaphoid fracture condition page.

What Happens During Scaphoid Fracture Surgery

Scaphoid fracture surgery is usually an outpatient procedure, so you go home the same day. It is performed under anesthesia, and your surgeon will discuss the type that is right for you. The surgeon repositions the broken bone into proper alignment and secures it, most often with a specially designed screw placed inside the bone, so the pieces are held firmly together while they heal. When the bone is badly broken or slow to heal, the surgeon may add a small bone graft to encourage healing, especially for a fracture closer to the forearm. Depending on the fracture, the repair can sometimes be done through a small incision using a less invasive technique. Your surgeon will explain which approach fits your injury.

Recovery After Scaphoid Fracture Surgery

After surgery, your wrist is protected in a cast or splint, often a thumb spica that includes the thumb, while the bone heals, and your physician will monitor healing with follow-up imaging. Because the scaphoid heals slowly, this takes patience, and the internal fixation helps by adding stability during that time. Your physician will let you know when it is safe to come out of the cast and begin rebuilding motion and strength, often with the help of hand therapy. Full recovery commonly takes a few months, and returning to sports or heavy use of the wrist before the bone has healed raises the risk of problems, so it is worth following your physician’s timeline. Many patients regain dependable wrist function once the bone has healed.

Risks of Scaphoid Fracture Surgery

As with any operation, scaphoid fracture surgery carries risks to discuss, including infection, nerve irritation, stiffness and the chance that the bone does not fully heal. That risk is higher for fractures closer to the forearm, where the blood supply is most limited. A fracture that does not heal is one of the main concerns this surgery is designed to prevent, since it can lead to ongoing pain and wrist arthritis over time. Your Resurgens surgeon will review the risks specific to your fracture and your health before you decide on surgery.

Schedule an Appointment for Scaphoid Fracture Care

If you have wrist pain after a fall, or a scaphoid fracture that is not healing, do not wait to have it evaluated. Book an appointment online today with Resurgens Orthopaedics or call us at (404) 847-9999.