A navicular fracture involves a break in a small-sized bone on the thumb side of the wrist. It is important to note that the navicular bone is likely to break among the carpal bones in the wrist.
This type of fracture requires treatment to promote proper healing. With proper treatment and follow-up care, most cases heal over time. If not treated or even with treatment, the healing process is slow and difficult since parts of the navicular bone does not have a good blood supply. If the bone does not heal properly, the individual will experience lasting pain, stiffness or even wrist arthritis.
What are the causes?
Most cases occur when stretching the hand out in front to protect against a fall. The fracture can also occur when the wrist is severely twisted or struck very hard. A navicular fracture often occurs while the individual is playing sports such as soccer, football or basketball or during activities such as skateboarding, in-line skating or biking.
Indications of a navicular fracture
Since a navicular fracture does not causes deformity of the wrist along with minor symptoms, it is difficult to know if the navicular bone is fractured. If the bone is damaged, the following are present:
- Tenderness, pain or swelling on the thumb side of the wrist
- Difficulty gripping or grabbing objects or moving and twisting the wrist or thumb
- Bruises around the wrist
It is difficult to differentiate between a wrist sprain and one that is fractured. If an individual has fallen on an extended hand and the wrist is sore, a doctor must be seen to determine if any bones are broken.
Management
The treatment for a navicular fracture involves the use of an arm cast or splint or even surgery. Even if the initial X-rays do not reveal a fracture, the doctor might advise treatment to prevent possible issues with healing.
After the injury, a splint is worn since it might still be swollen for a cast to be used. During the first few days, the doctor will instruct the individual to keep the wrist elevated than the level of the heart and apply an ice pack to reduce the swelling. A pain medication might also be prescribed such as acetaminophen or ibuprofen.
In some cases, once the swelling has settled, the splint is removed and a cast is placed. This cast encloses the thumb and might even extend above the elbow. The cast must be worn for 6 weeks while others should wear it for several months.
Surgery might be required to restore the bone fragments in the right position or to promote faster bone healing. It is also required if a region of the bone has died due to lack of blood supply. If surgery was performed, a splint or cast is used after.
Quick Note / Disclaimer
The material posted on this page on a navicular fracture is for learning and educational purposes only. To learn to recognize and manage fractures including the navicular bone, register for a first aid and CPR course with one of our training providers.