S62.03 Fracture of proximal third of navicular [scaphoid] bone of wrist

Name of the Condition

• Fracture of proximal third of navicular [scaphoid] bone of wrist

Summary

A fracture of the proximal third of the navicular (scaphoid) bone is a break in the upper portion of one of the wrist's small bones, near the base of the thumb. This area is critical for wrist stability and movement. Fractures in this region may vary in severity, from minor cracks to complete breaks, and can involve displacement of bone fragments.

Causes

Typically results from a fall onto an outstretched hand (FOOSH), which applies significant force to the scaphoid bone. Can also occur due to direct trauma, such as a blow or impact to the wrist, or twisting injuries during high-impact activities.

Risk Factors

• Participation in contact sports or activities with a high risk of falls.
• Osteoporosis or weakened bone structure, particularly in older adults.
• Previous wrist injuries or fractures.

Symptoms

• Pain and tenderness in the wrist, especially at the base of the thumb.
• Swelling and bruising around the wrist area.
• Decreased range of motion or difficulty gripping objects.
• Possible numbness or tingling if nerves are affected.

Diagnosis

Physical examination to assess pain, swelling, and wrist mobility. Imaging tests, such as X-rays, CT scans, or MRI, to visualize the fracture and determine displacement.

Treatment Options

• Immobilization with a cast or splint to allow the bone to heal.
• Pain management with nonsteroidal anti-inflammatory drugs (NSAIDs).
• In some cases, surgery may be required to realign or stabilize the fracture.

Prognosis and Follow-Up

Healing time depends on fracture severity and treatment. Proximal third fractures may take longer to heal due to limited blood supply. Follow-up imaging and physical therapy are often necessary to monitor progress and restore function.

Complications

• Nonunion (failure to heal) or delayed union.
• Avascular necrosis (loss of blood supply to the bone).
• Arthritis or chronic pain in the wrist.

Lifestyle & Prevention

• Use protective gear during high-risk activities.
• Maintain bone health through proper nutrition and exercise.
• Avoid falls by improving balance and using assistive devices if needed.

When to Seek Professional Help

Seek immediate care if you experience severe wrist pain, swelling, or inability to move the wrist after an injury. Persistent pain, numbness, or tingling also warrants medical evaluation.

Tips for Medical Coders

Document the fracture location (proximal third of the navicular/scaphoid bone) and any associated details, such as displacement or treatment, to ensure accurate coding. Include clinical notes supporting the diagnosis and any imaging results.