Scaphoid fracture with AVN

Discussion:

Scaphoid fracture key points:

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

Avascular necrosis of the scaphoid key points:

  • occurs 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 ischemia of the proximal pole
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