Scaphoid fracture with AVN

Scaphoid Fracturefracture with AVN

26 year old female with persistingPersisting left wrist and anatomical snuff box pain 8 weeks after FOOSH. PrivateA plain x-ray was unremarkable at the time of injury.

Scaphoid Fracture Key Pointsfracture key points:

• Mostmost common carpal bone fractured
• 10% of scaphoid fractures have an associated fracture of another bone.
• 70% involve the waist. 10, 10-20% the distal pole, and 5-10% the proximal pole.

Avascular Necrosisnecrosis of the Scaphoid Key Pointsscaphoid key points:

• Occursoccurs in 15-30% of scaphoid fractures
• almost always involves the proximal pole
• up to 30% of scaphoid fractures may display increased density of the proximal pole
• the more proximal the fracture, the higher the risk of AVN
• the radiographic hallmarks of AVN are collapse and fragmentation
• often reversible
• may be due to relative ischaemia of the proximal pole

Scaphoid Fracture with AVN

CT of the left wrist demonstrates minimally displaced-displaced scaphoid waist fracture with increased sclerosis of the proximal pole. No widening of the scapholunate interval. Subtle lucent line through the pisiform may represent an undisplaced fracture.