Cast treatment for a broken scaphoid

The scaphoid sits on the thumb side of the wrist and has a blood supply that can make healing less predictable in some fracture locations. Keeping scheduled reviews matters even when pain improves.

A clinician chooses the cast design according to the fracture position and stability. It commonly limits wrist movement and may also include the thumb. The cast holds the area quiet; it does not provide proof that the bone has united.

Examinations and imaging help the treating team judge progress. A cast may be replaced if swelling settles and it becomes loose, or changed as treatment advances. A fracture that shifts, heals poorly or has features that make union difficult may prompt discussion of fixation surgery.

Keep the cast clean and dry, and avoid pushing pens, creams or powders beneath it. Move the uncovered fingers regularly, keep the hand raised when swelling increases, and check that rings have been removed. Do not modify the thumb section or cast edges yourself.

Use the hand only within the limits set by your clinician. Lifting, gripping and leaning body weight through the cast can stress the injured area even if discomfort is mild. Attend every planned review and describe any new tenderness on the thumb side of the wrist after cast changes.

Get urgent help if fingers become numb, weak, pale, blue or cold, or if increasing swelling makes the cast feel tight. Severe or escalating pain, especially when it does not improve with elevation and prescribed pain relief, also requires prompt assessment.

Contact the fracture service if the cast cracks, becomes wet or loose, rubs the skin, or develops drainage or a foul smell. Fever with increasing pain or redness around the cast edges may indicate infection and should be assessed without delay.

Ask where the fracture lies, whether it is displaced, and how those details affect the plan. Confirm when imaging will be repeated, what will show that healing is adequate, and whether the thumb must remain immobilised.

Discuss when driving, work, lifting and sport can resume. Before the cast comes off, ask how to restart wrist motion safely and whether stiffness or weakness warrants supervised rehabilitation.