Scaphoid fracture
Classification and external resources
ICD-10	S62.0
ICD-9	814.x1
eMedicine	emerg/844 radio/747 plastic/318 pmr/127

A Scaphoid fracture (a fracture of the scaphoid bone) is the most common type of wrist fracture.^[1] Scaphoid fractures usually cause pain at the base of the thumb accompanied by swelling in the same area. Treatment depends on the location of the fracture. Also called a navicular fracture, this bone can be notoriously hard to heal.

Contents 1 Diagnosis 2 Complications 3 References 4 External links

[edit] Diagnosis

Clinically patients present with snuff box tenderness.

Scaphoid fractures are often diagnosed by X-rays. However not all fractures are apparent initially. Therefore people with tenderness over the scaphoid are often casted for 7–10 days at which point a second set of X-rays is taken. If there was a hairline fracture, healing will now be apparent. Even then a fracture may not be apparent. A CT Scan can then be used to observe the snuff box area more precisely. Fractures can take between 6 and 12 weeks of casting. The Scaphoid has its own blood flow unlike other carpal bones. Blood flows from the top/proximal of the bone; if this blood flow is disrupted by a fracture, the bone may not heal. Surgery is necessary at this point to mechanically mend the bone together.

The use of MRI if available can give one an immediate diagnosis.^[2]

[edit] Complications

Avascular necrosis (AVN) is a common complication of a scaphoid fracture. Risk of AVN depends on the location of the fracture.

• Fractures in the proximal 1/3 have a high incidence of AVN
• Waist fractures in the middle 1/3 is the most frequent fracture site and has moderate risk of AVN.
• Fractures in the distal 1/3 are rarely complicated by AVN.

Non union can also occur from undiagnosed or undertreated scaphoid fractures.

[edit] References

[edit] External links

• AAFP: Diagnosis and Management of Scaphoid Fractures
• Wheeless: Scaphoid fracture
• http://www.med.umich.edu/1libr/aha/aha_navicfx_art.htm
• http://sprojects.mmi.mcgill.ca/icmcradiology/radcase.aspx?IDCase=6&CaseDiag=D

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