How To Diagnose Scaphoid Fractures | Physical Therapy Evaluation

By dpope2020

April 21, 2023

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How To Diagnose Scaphoid Fractures | Physical Therapy Evaluation

In today's episode we go over How To Diagnose Scaphoid Fractures | Physical Therapy Evaluation:

As physical therapists, we know the importance of accurate diagnosis when it comes to treating our patients. When it comes to scaphoid fractures, a proper diagnosis is crucial for ensuring proper treatment and avoiding long-term complications.  No one likes a dead bone in their wrist and if we don't make the right call we may be leading our patients down a bad path...

The scaphoid bone is a small bone located in the wrist, and it can be easily fractured during a fall or other trauma. However, these fractures are often difficult to detect and can be easily missed on an X-ray.  Folks training in the gym place a lot of stress on the wrist during movements like bench press, olympic lifts and during handstand skills.  Often times the wrist becomes pretty irritated.

If a scaphoid fracture is not properly diagnosed and treated, it can lead to long-term complications such as chronic pain, reduced grip strength, and arthritis.

That's why it's important for physical therapists to be aware of the signs and symptoms of a scaphoid fracture, and to work closely with physicians to ensure an accurate diagnosis.

Symptoms of a scaphoid fracture may include pain and swelling in the wrist, particularly in the area near the thumb. Patients may also experience difficulty gripping or holding objects.

If a scaphoid fracture is suspected, it's important to refer for medical attention and imaging right away. X-rays may not always show the fracture, so additional imaging such as a CT scan or MRI may be necessary.

So if you suspect a scaphoid fracture it's time to refer your patient to a physician...

Check out the video below to see how I like to evaluate patients for scaphoid fractures:

By working closely with physicians to ensure an accurate diagnosis and providing appropriate treatment, physical therapists can help patients with scaphoid fractures avoid long-term complications and return to training as quickly and safely as possible

No dead wrist bones!

- Dan Pope PT, DPT, OCS, CSCS

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Thank you!

Dan Pope DPT, OCS, CSCS

References:

  1. B├Ącker HC, Wu CH, Strauch RJ. Systematic Review of Diagnosis of Clinically Suspected Scaphoid Fractures. J Wrist Surg. 2020 Feb;9(1):81-89. doi: 10.1055/s-0039-1693147. Epub 2019 Jul 21. PMID: 32025360; PMCID: PMC7000269.
  2. Mallee WH, Henny EP, van Dijk CN, Kamminga SP, van Enst WA, Kloen P. Clinical diagnostic evaluation for scaphoid fractures: a systematic review and meta-analysis. J Hand Surg Am. 2014 Sep;39(9):1683-1691.e2. doi: 10.1016/j.jhsa.2014.06.004. Epub 2014 Aug 1. PMID: 25091335.