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Scaphoid Fracture

Scaphoid Fracture is a topic covered in the 5-Minute Emergency Consult.

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Basics

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 3rd (10–20%)
    • Middle 3rd (the waist, 70–80%)
    • Distal 3rd (the tuberosity)
    • 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
  • 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).

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Citation

Rosen, Peter, et al., editors. "Scaphoid Fracture." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307521/all/Scaphoid_Fracture.
Scaphoid Fracture. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307521/all/Scaphoid_Fracture. Accessed April 23, 2019.
Scaphoid Fracture. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307521/all/Scaphoid_Fracture
Scaphoid Fracture [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307521/all/Scaphoid_Fracture.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Scaphoid Fracture ID - 307521 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307521/all/Scaphoid_Fracture PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -