The scaphoid is one of the small bones which make up the wrist. It is located on the thumb side of the wrist. It is an important bone for movement and stability of the wrist. The scaphoid can be injured by a fall onto an outstretched hand, by a blow to the wrist or from punching.
Scaphoid Fracture Symptoms
The main symptoms of scaphoid fracture may include:
- pain and tenderness in the area just below the base of the thumb (the anatomic snuffbox).
- swelling
- bruising or discoloration
- inability to move your thumb or wrist
- lack of grip or pain when gripping or lifting objects
- a deformity or bump on your wrist
Negligence
Unfortunately, scaphoid fractures can get missed, often by those working in the front-line services such as GPs and in Accident and Emergency.
It can be difficult to see scaphoid fractures on an x-ray, especially straight after the injury, it is therefore important that proper examination is carried out. If a fracture cannot be visualised on an x-ray, a patient should be advised of the difficulties in diagnosing scaphoid fractures and told to return if the symptoms persist.
Examination should include:
- History – Taking a detailed history from the patient of how the injury was caused and when;
- Physical examination – To identify the location of any pain, swelling or bruising. Assess whether pain increases/decreases with movement and if there is any loss of movement. Checks of the hand, wrist and thumb/fingers should be made. The anatomic snuffbox in particular should be checked;
- X-rays – Should be taken from different angles.
You may be able to pursue a claim for medical negligence if there was a failure to perform reasonable examination of the hand/wrist and an x-ray or a failure to advise of the difficulties in diagnosing scaphoid fractures and told to return if the symptoms persist for further x-rays.
X-rays taken at a later date often show a fracture more readily, so further investigations may be required to confirm the presence of a fracture.
On the other hand, if a radiographer fails to detect a scaphoid fracture when it is clearly visible on the x-ray, there may have been an unreasonable delay in diagnosis.
Complications
If scaphoid fractures are reasonably and promptly diagnosed, surgery is usually not required. If a scaphoid fracture remains undiagnosed it can cause complications which may include:
- bone non- union
- malunion (where the bone heals in the wrong position)
- problems with blood supply and the death of bone tissue (avascular necrosis)
- arthritis
This may lead to needing surgery or multiple operations to try and rectify the bone positioning.
Missed diagnosis of a scaphoid fracture can have significant impact on the individual causing pain, suffering and in severe cases result in problems working or perhaps force early retirement.
Contact Us
For free confidential advice on how we can help you with making a medical negligence claim contact us on 0113 284 5000 or clinneg@isonharrison.co.uk
