Scaphoid fractures are the most commonly fractured carpal bone, accounting for 2-3% of all fractures and ~10% of all hand fractures.
Scaphoid fractures are the most commonly fractured carpal bone, accounting for 2-3% of all fractures and ~10% of all hand fractures. They account for approximately 60% of all carpal fractures. There is a male predominance with low-energy falls being the most common etiology although men are more likely to sustain their fracture after a high-energy injury.
Approximately 65% of injuries occur at the waist, with another 25% occuring in the proximal third. The major blood supply of scaphoid is provided by the dorsal carpal branch of the radial artery which provides retrograde flow to the proximal 80% of scaphoid via an intraosseous supply. The superficial palmar arch supplies the distal 20%.
This intraosseous retrograde flow makes the scaphoid particular susceptible to avascular necrosis, which can lead to scaphoid nonunion and eventual collapse (termed SNAC: scaphoid nonunion advanced collapse). Avascular necrosis, sometimes termed Preiser’s disease, is reported to occur anywhere from 13-50% of scaphoid fractures, with the highest incidence in the proximal 1/5th of the scaphoid. Missed scaphoid fractures have a high risk of nonunion or malunion.
Nonunion occurs in up to 12% of patients if an occult fracture is not detected and treated. For these reasons, early detection and appropriate treatment is critical in avoiding chronic, debilitating wrist problems associated with missed scaphoid fractures. History and Physical Scaphoid fractures tend to occur in young and middle aged men.
As patients age, the distal radial metaphysis is much more likely to fail than the scaphoid. The typical mechanism involves falling onto a hyperextended wrist with radial deviation. The hand and wrist should be observed for any signs of soft tissue swelling, effusion, ecchymosis or deformities.
If you are experiencing symptoms that may be related to scaphoid fractures diagnosis & management, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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