A scaphoid "non-union" fracture refers to a wrist fracture that is failing to heal. A fracture that is healing more slowly than expected is a "delayed union" fracture.
The scaphoid is one of the eight small bones in the wrist. These small bones are arranged into two rows (Figure 1). During normal wrist motion, the wrist bones move together to allow the wrist to achieve many positions that we take for granted. The scaphoid spans these two rows; in a way, it "directs" the motion of the other small bones.
The scaphoid can be injured when a significant load is placed on the extended wrist, such as a fall onto an outstretched hand. If the scaphoid is broken, the few tiny blood vessels that supply the bone with nutrients can be damaged. Because blood supply is needed to heal a fracture, the scaphoid often takes a long time (a few months) to heal.
Most people with a scaphoid fracture will have pain and/or swelling along the thumb-side of the wrist.
Diagnosis is confirmed most commonly with x-rays (Figures 2a and 2b). Sometimes, a CT scan and/or MRI is used to get better views of the shape and alignment of the scaphoid and assist with the diagnosis or surgery plans.
If the scaphoid fracture does not heal, you may or may not continue to have symptoms. It may be a sign that your fracture is not healing if you notice decreased strength, such as inability to do push-ups.
Treatment of a scaphoid non-union depends on many factors, including: