Scaphoid Fracture

Description

• The scaphoid is the most commonly fractured carpal bone
• This bone is the stabilizer between the distal and proximal carpal rows
• Injury may result in arthritis, avascular necrosis, or malunion
• Classified as:
  • Proximal third (25%)
  • Middle third (the waist, 65–70%)
  • Distal third (the tuberosity, 5–10%)
  • Tubercle fractures
• Fractures are missed on initial radiographs 10–15% of the time, and delayed diagnosis greatly increases risk of complications
• The blood supply to the scaphoid enters distally
• The more proximal the fracture, the higher the likelihood for avascular necrosis; 30% in proximal third fractures
• As the wrist is forcibly hyperextended, the volar aspect of the scaphoid fails in tension and the dorsal aspect fails in compression resulting in a fracture

Etiology

Generally results from a fall on an outstretched (dorsiflexed) hand (FOOSH injury)