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The information on this page is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.
Always seek the advice of your doctor or other qualified health professional with any questions you may have regarding a medical condition.
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Scaphoid Nonunion (Non-Healing Wrist Fracture)
Scaphoid nonunion occurs when a scaphoid wrist fracture fails to heal after 3-4 months of treatment, affecting 5-10% of scaphoid fractures - it causes persistent wrist pain, weakness, and leads to early wrist arthritis within 5-10 years if untreated, requiring surgical bone grafting and screw fixation with 80-90% success rate in achieving healing and preventing arthritis progression.
📖What is Scaphoid Nonunion (Non-Healing Wrist Fracture)?
Scaphoid nonunion occurs when a scaphoid wrist fracture fails to heal after 3-4 months of treatment, affecting 5-10% of scaphoid fractures - it causes persistent wrist pain, weakness, and leads to early wrist arthritis within 5-10 years if untreated, requiring surgical bone grafting and screw fixation with 80-90% success rate in achieving healing and preventing arthritis progression.
🔬What Causes It?
- Delayed or missed diagnosis of initial scaphoid fracture (fracture invisible on first X-rays, not immobilized)
- Inadequate immobilization or cast removed too early (patient compliance issues)
- Proximal pole fractures with poor blood supply (15-30% nonunion rate)
- Displaced fractures more than 1mm not treated surgically
- Smoking during fracture healing (doubles nonunion risk)
⚠️Risk Factors
You may be at higher risk if:
- Proximal pole scaphoid fractures (poor blood supply to bone)
- Displaced fractures treated conservatively without surgery
- Smoking (impairs bone healing)
- Delayed diagnosis more than 4 weeks after injury
- Previous failed scaphoid surgery
🛡️Prevention
- ✓Treat suspected scaphoid fractures immediately even if X-rays normal (prevents missed diagnosis)
- ✓Ensure adequate cast immobilization duration (minimum 8-12 weeks for waist fractures)
- ✓Quit smoking if scaphoid fracture diagnosed (reduces nonunion risk by 50%)
- ✓Follow up with repeat X-rays to confirm healing before removing cast
- ✓Consider surgical fixation for high-risk fractures (proximal pole, displaced) rather than prolonged casting