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 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)

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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 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)

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