Scaphoid Fractures

Most frequently fractured carpal bone

Aetiology

  • Often occurs due to a fall on outstretched hand

Clinical presentation

  • Pain and tenderness in the anatomical snuffbox

Investigations

  • Extra views taken at x-ray - AP, lateral, two obliques
  • Despite the extra views, scaphoid fractures can be invisible - a repeat x-ray after 10 days, or MRI scan, can be helpful to confirm or exclude a fracture

Management

  • Conservative - cast
  • Operative - percutanous screw fixation, ORIF

Complications

  • The dorsal branch of the radial artery (supplies 80% of the blood to the scaphoid) enters in the distal pole of the scaphoid and blood travels in a retrograde fashion towards the proximal pole
  • Fractures can compromise the blood supply → increased risk of non-union, AVN and early wrist OA
notion image