Frx thru Waist of the Scaphoid

- Discussion:
     - 70% of carpal frx occur at waist of scaphoid (narrow part of bone);
     - 90% heal after w/ immobilization, but there is 5-10% complication rate;
     - blood supply to the proximal portion is usually intact and healing will take place if adequately reduced;
              - if nutrient artery is damaged, however, AVN may occur;
     - vertical oblique frxs are the least stable waist frx because of shear forces acting on the site of the fracture;

- Radiograph

- Treatment:
    - healing time in cast is 8-12 wks, although may require upto 18 weeks;
    - up to 90% of patients can expect union;
    - if x-rays fail to clearly demonstrate trabeculae crossing site of frx, CT scan along axis of carpal scaphoid is performed;
    - ORIF:
           - in minimally displaced fractures, expect fracture union in about 6 weeks

Patterns of union in fractures of the waist of the scaphoid.

Internal Fixation of Acute Stable Scaphoid Fractures in the Athlete.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, December 21, 2012 11:32 am