Scaphoid Fracture
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Clinically Relevant Anatomy
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The scapoid is one of the 8 carpal bones of the wrist. It is made up of a proximal and distal pole which are joined by a waist. Scapohid fractures make up 50-80% of all carpal fractures. [1] Blood supply is provided by a subdivision of the radial artery and travels distal to proximal. The proximal pole has no direct blood supply and is prone to avascular necrosis (AVN).[2]
Mechanism of Injury / Pathological Process
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Mechanism of injury is usually a fall onto an outstretched arm with wrist hyperextended and radial deviation. This position causes axial loading through the scaphoid. Less common mechanisms of injury are:
- wrist extension with deceleration such as with the hand on a steering wheel
- 'kickback' injuries from machinery
- hyperflexion injuries
- direct impact to the scaphoid
Most injuries are seen in men aged 15-30. 75-80% of fractures occur through the waist of the bone. 15-20% occur at the proximal pole. 10-15% of fractures occur at the distal pole.[3]
Clinical Presentation[edit | edit source]
Clinical presentation includes swelling and pain over the anatomical snuff box. The anatomical snuff box is the area between the extensor pollicis longus and the extensor pollicis brevis. Patient will usually also complain of pain with pressure over the scapoid tubercle.
Diagnostic Procedures[edit | edit source]
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Management / Interventions
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Differential Diagnosis
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Resources
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References[edit | edit source]
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- ↑ Alshryda SJM, Shah AB, Rhodes S, Odak SS, Murali SR, Ilango B. Interventions for treating acute fractures of the carpal scaphoid bone in adults. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD006523. DOI:fckLR10.1002/14651858.CD006523.fckLRA B
- ↑ Bethel J. Scaphoid Fracture: diagnosis and management. Emergency Nurse. July, 2009. 17(4): 24-29.
- ↑ Bethel J. Scaphoid Fracture: diagnosis and management. Emergency Nurse. July, 2009. 17(4): 24-29.
