Scaphoid fracture - non-union

Case contributed by Heba Abdelmonem
Diagnosis almost certain

Presentation

Scaphoid fracture 7 months ago.

Patient Data

Age: 20 years
Gender: Male

Herbert screw internal fixation. 

Clearly defined fracture of the scaphoid waist. Mild reduction of density of the proximal scaphoid bone with small cysts.

Case Discussion

Fractures of the scaphoid waist represent 70% of the scaphoid fractures. Scaphoid malunion is defined as a visible fracture remaining after 4 months with casting. 

Scaphoid non-union is considered if the fracture line is identified after 7 months to a year.

In this particular case, the scaphoid fracture line is still identified after 7 months with Herbert screw fixation. Early avascular necrosis of the proximal scaphoid is demonstrated as reduced bone density with multiple areas of cystic changes.

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