Clinical importance
Scaphoid fractures can be missed and are at risk of non-union because of tenuous blood supply to the proximal pole.
Presentation
- Fall onto the outstretched hand
- Snuffbox tenderness
- Pain on scaphoid tubercle palpation
- Pain with axial loading of thumb may be present
Imaging
- Dedicated scaphoid radiographs
- MRI or CT if initial films are negative but suspicion remains
Treatment
- Stable distal or waist fractures may be treated in cast or by fixation depending on pattern and patient needs
- Displaced fractures usually need fixation
Non-union
May lead to SNAC wrist. Treatment depends on site, deformity, vascularity and arthritis, and may include bone grafting and fixation.
Diagram
