Fractured Scaphoid

Ray Ballinger, MD, PhD

Straub Clinic and Hospital

rballinger at straub.net

Abstract

38 y/o man in skate board accident

Keywords

msk plain film


Publication Date: 10 November 2003
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History and Images

20 y/o student fell off his bicycle.

click to enlarge

Findings and Diagnosis

A lucent line crosses the scaphoid consistent with a fracture.

The image below was obtained two weeks post op for internal reduction with a screw.

Discussion

The scaphoid or navicular is the most frequently fractured carpal bone usual occuring from a fall onto an outstretched hand especially when the wrist is radially deviated. It is important to detect because the blood supply to the navicular is tenuous leaving to risk of avascular necrosis of the distal fractured fragment. Oblique "scaphoid" views may be helpful in detecting a subtle fracture. MRI may be occasionally useful for clinically suspicious but x-ray negative studies. Alternatively, the wrist may be immobilized for 2 weeks and x-rays repeated.