Presentation
Wrist pain after fall.
Patient Data
Fractured scaphoid. Does it look acute or chronic.
Fracture through the waist with sclerosis. This is an old, non-united scaphoid fracture.
The fracture line through the waist of the scaphoid is again demonstrated with volar subluxation of the distal scaphoid fragment resulting in a secondary humpback type deformity. Chronic non-union has resulted in a pseudo-arthrosis at the level of the waist. T2 marrow edema in the proximal pole of the scaphoid is consistent with scaphoid viability. Focal T1 low signal along the distal scaphoid pole is consistent with either early degenerative change or results from a previous fracture. The scapholunate ligament and alignment are normal. The TFCC complex is intact.
Comment Chronic waist of scaphoid fracture pseudoarthrosis with humpback deformity. Normal marrow signal in the proximal scaphoid pole with no collapse or significant sclerosis which are findings consistent with scaphoid viability.
Case Discussion
Scaphoid waist nonunion fracture with secondary humpback deformity.