Presentation
3 months post FOOSH.
Patient Data
Age: 45 years
Gender: Male
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The scaphoid waist fracture demonstrates loss of normal alignment, with new displacement since the initial radiographs.
There is subtle new sclerosis within the proximal pole indicating evolving avascular necrosis.
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Initial radiograph 3 months prior. Subtle undisplaced scaphoid waist fracture.
Case Discussion
The scaphoid bone is the most common carpal fracture.
- 65% of all fractures involve the waist
- 15% proximal pole
- 12% distal pole (more common in kids)
- 8% tubercle
Risk of scaphoid non union and AVN is dependent on the location of the fracture, due to the retrograde dorsal arterial supply (from distal to proximal).
- proximal pole fractures have a high risk of AVN (30%), up to 100% in proximal 1/5 fractures
- waist fractures, uncommon
- distal pole fractures, rare
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