How to Care for Your Child with a Suspected Scaphoid Fracture

Scaphoid fracture can occur following:

• Fall on outstretched hand.
• Blow to the wrist.
• Car accident.

Symptoms of scaphoid fracture include:

• Pain.
• Swelling around the wrist
• Tenderness.
• Inability to move the wrist or/and thumb.

The doctor will ask few questions about your child’s health and examine your child. Your doctor may request X-Ray of your child’s wrist.

Based on the clinical assessment and the x-ray finding, the doctor will be able to advise you about the treatment options that may include:

• Removable Splint (splint is like a cast but it has a soft covering  that allows room for swelling).
  • If a splint is used, your child will be given a follow up appointment within 10 days
  • A repeat x-ray may be required, and the splint may be changed to a full cast.
  •     Some types of fracture can only be managed by certain types of splints.
• Cast
  • If a cast was placed, your child will be given an appointment for regular follow up until the fracture has healed, this may take up to 12-14 weeks
• Surgery
  • On rare occasions, some fractures may need surgery to fix the broken bone.

• Leave the splint or cast in place until it is removed by your health care provider.
• If your doctor advises to give pain medicine, you can give:
  • Paracetamol (any brand) or Ibuprofen (any brand)
  • Follow the instruction on the medicine package for the correct dose for your child
  • Do not give your child Aspirin as this can cause serious complications
• For swelling and pain in the first 24 – 48 hours after the injury:
  • Use pillows to raise the wrist of your child above the level of his heart.
  • Apply cold packs wrapped in a towel to the cast or splint for 20 – 30 min every 3 – 4 hours.
• Encourage your child to wiggle his fingers to keep blood circulating normally.

• Do not get the cast or splint wet. your child should bath instead of shower, and use a plastic cover while bathing and keep it completely out of the water.
• Do not put anything inside the splint or cast (including objects, fingers, lotions or powders).
• Do not blow hot air in the cast, for itching use a cool hair dryer or blow air in and around the edges of the cast or splint.

Seek medical advice if:

• Your child gets a fever without a clear reason.
• Your child’s pain is not relieved by pain medication or gets worse.
• There are blisters, rashes, or raw spots on the skin around the cast or splint.
• A bad smell or discharges comes from the cast or splint.

Go to the Emergency Department if:

• Your child fingers turn numb, tingly, pale or blue.
• The cast or splint feels too tight or too lose.
• The cast or splint gets wet, cracks or falls off.