Non-united scaphoid fracture with proximal pole avascular necrosis

Case contributed by RMH Core Conditions

Presentation

Increasing right wrist pain.

Patient Data

Age: 34
Gender: Male

The fracture line in the scaphoid is still present. Sclerosis is noted at the fracture margins along with increased density of the proximal pole fracture fragment with cystic degenerative change.  

 

There are chronic changes in the scaphoid with an ununited fracture through the waist.

The proximal pole is small and sclerotic, with cystic change on the volar aspect. The non cystic portion shows no marrow oedema.

There is degenerative marrow oedema signal in the distal scaphoid bone, with mild surrounding radioscaphoid synovitis.

The dorsal scapholunate ligament shows increased signal consistent with a chronic tear.

The lunate, distal radius, capitate show normal signal. There is minor degenerative change at the STT joint.

CONCLUSION

Chronic ununited waist of scaphoid fracture, with advanced avascular necrosis of the proximal pole and cystic change.

Case Discussion

Avascular necrosis is a well established complication of proximal pole scaphoid fractures. 

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Case information

rID: 33623
Case created: 19th Jan 2015
Last edited: 10th Sep 2015
Inclusion in quiz mode: Included

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