Scaphoid fracture

Case contributed by Dr Jack Ren

Presentation

Fell back on extended wrist. Presents with pain, swelling, erythema, snuff box tenderness.

Patient Data

Age: 23 years
Gender: Male
X-ray

X-ray 12 hours post injury

A subtle lucency through the waist of the scaphoid is visible in only one plane. Also noted is an old malunited fracture of 5th metacarpal.

X-ray

X-ray 1 week later

There is a simple oblique fracture with no displacement on the waist of  right scaphoid bone . There is perhaps slight density difference between the two poles, the proximal appearing perhaps marginally denser. 

X-ray

X-ray 3 month later

There is increase lucency at the site of fracture in keeping with non-union. In addition the proximal pole is notably more sclerotic in keeping with AVN. 

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