What is the appropriate management protocol for a confirmed scaphoid fracture in an adult patient?

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

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

Appropriate management protocol for a confirmed scaphoid fracture in an adult patient:

  • Perform a thorough clinical examination and consider MRI as first-line imaging to confirm the diagnosis of a scaphoid fracture.
  • Immobilise the wrist using an appropriate splint or cast to prevent movement and promote healing.
  • Provide pain management tailored to the severity of pain, typically starting with oral analgesics such as paracetamol and escalating as needed.
  • Arrange for orthopaedic follow-up to monitor fracture healing and assess the need for surgical intervention if there is displacement or non-union risk.
  • Provide verbal and written information to the patient about expected outcomes, rehabilitation, and signs of complications.

This approach aligns with the NICE guideline on non-complex fractures, which recommends MRI for suspected scaphoid fractures after clinical examination and emphasises immobilisation and appropriate pain management in adults, with orthopaedic follow-up for definitive care planning .

Educational content only. Always verify information and use clinical judgement.