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Last reviewed: 07.07.2025
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Os scaphoideum – the scaphoid bone is part of the wrist structure as a bone of the anterior row, occupying the so-called radial position (lateral zone). The back of the bone is a very thin strip that continues to the wrist joint – the epiphysis of the radius, the palmar zone articulates with the tuberculum ossis scaphoidei – a tubercle of the scaphoid bone. The lower lateral part of the scaphoid bone connects with the trapezoid bone. Such a multifaceted property to connect with different bone structures and a rather fragile structure of the os scaphoideum determines its vulnerability in terms of mechanical injuries. A scaphoid cyst is often mistaken for fibrous neoplasms in this anatomical zone, especially in sports injuries, as well as in people doing monotonous work with their hands. A bone cyst, in principle, develops asymptomatically, similar to other benign tumor-like formations of the wrist, so differential diagnostics should become information that determines the treatment path for the neoplasm.
[ Symptoms of a scaphoid cyst
Symptoms of a scaphoid cyst may include:
- Transient pain in the wrist after physical activity.
- A slight swelling in the area of the scaphoid bone.
- Without adequate treatment and immobilization of the wrist, the cyst can grow and manifest itself as constant aching pain.
- An enlarging cyst can trigger a stress fracture with a minor bruise or when putting weight on the wrist during a fall.
- Since the scaphoid bone is not supported by a periosteum, the fracture may not feel like a severe injury and may be perceived as a simple sprain. In such situations, refractive (repeated) fractures are possible, causing visible deformity of the wrist.
Treatment of scaphoid cyst
Treatment of cystic tumors in the wrist is considered complex, quite traumatic and accompanied by a risk of complications.
The objectives of treating a cyst in the scaphoid bone:
- Tumor decompression, gradual reduction of pathological intraosseous pressure.
- Neutralization of aggressive proteolysis and fibrinolysis.
- Fixation of the bone both in the case of a diagnosed cyst and in the case of a tumor complicated by a fracture.
- Procedures that help activate bone tissue regeneration are compression (intraosseous pinning), stretching (distraction).
- Correction of a deformed wrist using a device.
Small and timely detected scaphoid bone cysts are treated conservatively using multiple punctures and corticosteroid injections. However, this method is fraught with relapses, so after 1-2 months of monitoring the cyst, the patient is most often offered to remove the cyst surgically. Excochleation of the tumor is performed, followed by bone autografting and the administration of drugs that promote bone tissue restoration. High-quality osteosynthesis is possible with long-term use of calcium preparations in combination with vitamin D (alfacalcidol). The process of graft implantation depends on the characteristics of bone nutrition, the age of the patient. In children, such pathologies are treated faster and wrist functions are restored within six months. Patients over 45 years of age are treated for a long time, the probability of adequate fusion of the damaged scaphoid bone does not exceed 50%.