What are the common complications associated with untreated scaphoid fractures, and how can they be prevented?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Common complications of untreated scaphoid fractures include non-union, avascular necrosis, chronic pain, decreased wrist function, and potential development of wrist arthritis due to the scaphoid's precarious blood supply and role in wrist stability.

Strategies to prevent these complications involve early and accurate diagnosis, often using MRI as first-line imaging when clinical suspicion is high despite normal initial X-rays, to avoid missed fractures.

Prompt immobilisation with appropriate splinting or casting is essential to promote healing and prevent displacement.

Regular follow-up and orthopaedic assessment are important to monitor healing and identify any signs of non-union or complications early.

In cases where displacement or non-union is detected, timely surgical intervention such as fixation may be required to restore anatomy and function.

Providing patients with clear verbal and written information about their injury, expected outcomes, and the importance of adherence to immobilisation and follow-up helps improve compliance and outcomes.

These approaches align with NICE recommendations for fracture management emphasizing early imaging, appropriate immobilisation, patient education, and timely specialist referral to prevent long-term complications.

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