← Patient Resources
EN ES Kreyòl

After surgery

After Scaphoid Fracture Surgery

Fixing a scaphoid fracture with a small screw (ORIF). Healing is slow because the scaphoid has a limited blood supply, and the recovery is paced accordingly.

What was done

The broken scaphoid bone was stabilized with a small screw placed down the long axis of the bone (a headless compression screw). Depending on the fracture pattern, the screw was placed through either a small incision on the palm side of the wrist or a short incision on the back of the wrist. You have a soft bulky dressing or a thumb spica splint.

The first 2 weeks

  • Keep the dressing or splint on, clean, and dry. Do not remove it or get it wet.
  • Keep the hand elevated above the level of your heart as much as possible for the first 3 to 5 days.
  • Move the fingers often — full finger motion prevents stiffness.
  • No lifting, gripping, or loading with the operated hand.
  • Ice over the dressing (20 minutes on, 20 off) helps with swelling in the first few days.

2 weeks: suture removal and cast

  • Come in at 10 to 14 days for suture removal and a wound check.
  • Most patients are then placed in a thumb spica cast or a custom thumb spica splint. Duration depends on the fracture pattern and the imaging — most scaphoid ORIFs are in a cast or splint for about 6 weeks total.
  • If a simpler fracture was fixed with a robust screw and you are not a high-demand patient, a shorter cast duration is sometimes appropriate.

Imaging along the way

Scaphoid healing is monitored with x-rays and sometimes a CT scan. Unlike most fractures, the scaphoid often shows slow, subtle healing on plain films, and a CT scan is the best way to confirm that the bone is fully united. Expect a CT scan somewhere between 6 and 12 weeks if there is any uncertainty about healing on plain films.

Pain and expected symptoms

  • Pain is worst in the first 3 to 5 days and improves steadily after that. Most patients are off prescription pain medicine within the first week.
  • A dull ache in the wrist with weather changes or heavy activity is common for months.
  • Swelling in the thumb and hand during the first few weeks is normal.
  • Stiffness after the cast comes off is expected and improves with therapy.

Out of the cast: therapy and progression

  • At 6 weeks (sooner or later depending on the fracture), the cast or splint is removed and you begin gentle active range-of-motion exercises for the wrist and thumb.
  • A removable wrist brace is used for comfort during activity for several additional weeks.
  • Formal certified hand therapy is arranged for most patients, focused on restoring motion and then, later, strength.
  • Strengthening usually begins around 8 to 12 weeks, once the fracture is confirmed to be healed.

Activity

  • Driving: once the cast is off and you have comfortable wrist motion, usually around 6 weeks, and off prescription pain medicine.
  • Typing / desk work: within the cast or splint, in moderation, right away.
  • Return to light work: usually 2 to 4 weeks in a cast, depending on job.
  • Return to heavy manual work: 3 to 6 months, after fracture healing is confirmed and strength has returned.
  • Return to contact sport or high-impact activity: 4 to 6 months, and only after imaging confirms full healing.

Follow-up

Wound check and suture removal at 10 to 14 days. Cast check at 4 and 6 weeks, with x-rays. Possible CT scan at 8 to 12 weeks. Final follow-up at 4 to 6 months.

Why scaphoid healing is slow

The scaphoid has an unusual blood supply — the main blood vessel enters at the far end of the bone and flows backward into the rest of it. A fracture can interrupt that flow, which is why even a small, well-aligned scaphoid fracture can take 3 to 4 months to heal, and sometimes longer. Being patient with the recovery is not being overly cautious; it is the way the bone works.

Call the office right away if
  • You have a fever over 101°F
  • Fingers coming out of the cast are blue, pale, or cold, or if you cannot move them because of pain
  • The cast becomes wet through, cracked, or feels too tight
  • Pain is worsening instead of improving after the first few days
  • You have new numbness, tingling, or severe weakness in the hand

Related

About scaphoid fracture · Scaphoid non-union · Cast & splint care

Questions?

Call your office location for non-urgent questions:

See our office contact information for addresses and fax numbers.