- 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;
- 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;
- 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.