Scaphoid non-union
Last revised by Joshua Yap on 28 Feb 2023
Citation, DOI, disclosures and article data
Citation:
Jones J, Yap J, Rasuli B, et al. Scaphoid non-union. Reference article, Radiopaedia.org (Accessed on 10 Oct 2024) https://doi.org/10.53347/rID-10210
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rID:
10210
Article created:
22 Jul 2010,
Jeremy Jones ◉
Disclosures:
At the time the article was created Jeremy Jones had no recorded disclosures.
View Jeremy Jones's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Joshua Yap had no financial relationships to ineligible companies to disclose.
View Joshua Yap's current disclosures
Revisions:
10 times, by
9 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Scaphoid non union
- Scaphoid nonunion
- Non-united scaphoid fractures
Scaphoid non-union is one of the complications of scaphoid fracture because of the unique anatomy of the scaphoid and its vascular supply.
On this page:
Epidemiology
Scaphoid fractures have one of the highest rates non-union of all fractures at ~10% (range 5-15%) 3,4.
Pathology
Scaphoid non-union occurs most commonly through the middle or proximal thirds 1.
Classification
Six grades of non-union have been described by Slade and Dodds 2:
grade 1: delayed presentation - 4-8 weeks
grade 2: fibrous non-union - minimal fracture line; no cyst or sclerosis
grade 3: minimal sclerosis - <1 mm bone resorption with minimal sclerosis
grade 4: cyst formation and sclerosis - <5 mm bone resorption with cyst formation; normal scaphoid alignment
grade 5: cyst formation and sclerosis - 5-10 mm bone resorption with cyst formation; normal scaphoid alignment
grade 6: separate bone fragments with profound bone resorption; fragment motion and scaphoid deformity common
The following subtypes can also be applied:
a: proximal pole non-union
c: ligamentous injury
d: deformity
Complications
Quiz questions
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References
- 1. Ian A. Trail, Andrew Fleming. Disorders of the Hand. (2016) ISBN: 9781447171072
- 2. Janowski J, Coady C, Catalano LW. Scaphoid Fractures: Nonunion and Malunion. (2016) The Journal of hand surgery. 41 (11): 1087-1092. doi:10.1016/j.jhsa.2016.08.019 - Pubmed
- 3. Zura R, Xiong Z, Einhorn T, Watson JT, Ostrum RF, Prayson MJ, Della Rocca GJ, Mehta S, McKinley T, Wang Z, Steen RG. Epidemiology of Fracture Nonunion in 18 Human Bones. (2016) JAMA surgery. 151 (11): e162775. doi:10.1001/jamasurg.2016.2775 - Pubmed
- 4. Steinmann SP, Adams JE. Scaphoid fractures and nonunions: diagnosis and treatment. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association. 11 (4): 424-31. doi:10.1007/s00776-006-1025-x - Pubmed
- 5. Bervian MR, Ribak S, Livani B. Scaphoid fracture nonunion: correlation of radiographic imaging, proximal fragment histologic viability evaluation, and estimation of viability at surgery: diagnosis of scaphoid pseudarthrosis. (2015) International orthopaedics. 39 (1): 67-72. doi:10.1007/s00264-014-2579-4 - Pubmed
- 6. Michael G. Fox, Cree M. Gaskin, A. Bobby Chhabra, Mark W. Anderson. Assessment of Scaphoid Viability With MRI: A Reassessment of Findings on Unenhanced MR Images. (2012) American Journal of Roentgenology. 195 (4): W281-6. doi:10.2214/AJR.09.4098 - Pubmed
Incoming Links
Articles:
Cases:
- Scaphoid fracture with avascular necrosis
- Scaphoid non-union
- Scaphoid nonunion with humpback and DISI deformities
- Scaphoid nonunion with humpback deformity
- Scaphoid non-union
- Scaphoid fracture nonunion
- Scaphoid nonunion with humpback deformity
- Scaphoid non-union with avascular necrosis
- Non-united scaphoid fracture with avascular necrosis
- Scaphoid fracture and avascular necrosis
- Scaphoid avascular necrosis (contrast-enhanced MRI)
- Avascular necrosis - scaphoid non-union
- Scaphoid non-union
- Scaphoid pseudoarthrosis
- Ununited scaphoid fracture with dorsal intercalated segment instability and scaphoid non union advanced collapse
- Scaphoid non union advanced collapse
- Delayed healing in scaphoid fracture
- Scaphoid pseudoarthrosis
Multiple choice questions:
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