What is a Scaphoid Fracture?

A scaphoid fracture refers to a small scaphoid fracture in the wrist near the proximal row of the wrist. The surface of the scaphoid is mostly covered by articular cartilage. It is adjacent to the skull, lunar bone, and large and small polygonal bones. It has articular surfaces, so the blood supply is poor. Only two places have blood vessels entering the scaphoid: the nodule and the waist. Most of the fractures are located in the waist, and the blood flow of the proximal fracture is severely affected, resulting in slow fracture healing. There is often swelling and tenderness at the snuffbox after injury. X-ray diagnosis is needed. The treatment should be completely fixed with plaster, with the thumb in the opposite palm position and the wrist joint extended 30 °. Usually need to be fixed for 6 to 10 weeks. Some are delayed until half a year to a year before they heal. Fractures are prone to disconnect and require surgery. The unconnected soft tissue can be removed and implanted into the autogenous bone to heal the fracture. There are also proposals to perform a radial styloid resection to eliminate the factors that cause frequent disconnection at the fracture end, which can also achieve good results. ^[1]

Scaphoid fracture

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A scaphoid fracture refers to a small scaphoid fracture in the wrist near the proximal row of the wrist. The surface of the scaphoid is mostly covered by articular cartilage. It is adjacent to the skull, lunar bone, and large and small polygonal bones. It has articular surfaces, so the blood supply is poor. Only two places have blood vessels entering the scaphoid: the nodule and the waist. Most of the fractures are located in the waist, and the blood flow of the proximal fracture is severely affected, resulting in slow fracture healing. There is often swelling and tenderness at the snuffbox after injury. X-ray diagnosis is needed. The treatment should be completely fixed with plaster, with the thumb in the opposite palm position and the wrist joint extended 30 °. Usually need to be fixed for 6 to 10 weeks. Some are delayed until half a year to a year before they heal. Fractures are prone to disconnect and require surgery. The unconnected soft tissue can be removed and implanted into the autogenous bone to heal the fracture. There are also proposals to perform a radial styloid resection to eliminate the factors that cause frequent disconnection at the fracture end, which can also achieve good results. ^[1]

Basic overview

Fractures of the scaphoid bone are mostly caused by indirect violence. After the fracture, the dorsal side of the wrist is painful and swollen, especially in the crypt, and the movement of the wrist is impaired. Tilt the wrist radially, flexing the thumb and index finger (forefinger) and tapping the metacarpophalangeal joint can cause increased wrist pain. Fractures of the scaphoid bone are easily missed. To confirm the diagnosis, X-rays should be performed in time.

Classification of scaphoid fractures:

(1) Fracture of scaphoid tubercle. It is a distal fracture of the scaphoid bone and generally heals well.

(2) Lumbar fracture of the scaphoid. Due to poor local blood flow, healing is usually slow.

(3) Fracture of the proximal scaphoid. Proximal fractures are affected by blood flow and are prone to non-union and ischemic necrosis.