Scaphoid non-union

Scaphoid non-union is one of the complications of scaphoid fracture because of the unique anatomy of the scaphoid and its vascular supply.

Scaphoid fractures have one of the highest rates non-union of all fractures at ~10% (range 5-15%) 3,4.

Scaphoid non-union occurs most commonly through the middle or proximal thirds 1.

Six grades of non-union have been described by Slade and Dodds 2

  • grade 1: delayed presentation - 4-8 weeks
  • grade 2: fibrous non-union - minimal fracture line; no cyst or sclerosis
  • grade 3: minimal sclerosis - <1 mm bone resorption with minimal sclerosis
  • grade 4: cyst formation and sclerosis - <5 mm bone resorption with cyst formation; normal scaphoid alignment
  • grade 5: cyst formation and sclerosis - 5-10 mm bone resorption with cyst formation; normal scaphoid alignment
  • grade 6: separate bone fragments with profound bone resorption; fragment motion and scaphoid deformity common

The following subtypes can also be applied:

  • a: proximal pole non-union 
  • b: avascular necrosis (AVN)
  • c: ligamentous injury
  • d: deformity
Fractures
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Article information

rID: 10210
Synonyms or Alternate Spellings:
  • Non-united scaphoid fractures
  • Scaphoid nonunion
  • Scaphoid non union

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3
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  • Case 4: with proximal pole AVN
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  • Case 5: with SNAC
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