Scaphoid Fracture
A scaphoid fracture after a fall onto an outstretched hand can be occult on initial radiographs; immobilise clinical suspicion, obtain definitive imaging promptly, and escalate proximal or displaced injuries because retrograde blood supply makes non-union and avascular necrosis clinically important.
Definition
A scaphoid fracture is a break in the scaphoid, a carpal bone on the thumb side of the wrist. It is clinically important because a fracture can be occult on initial radiographs and the proximal fragment is vulnerable to non-union and avascular necrosis.
First principles
The scaphoid links the two carpal rows
The scaphoid is a key mechanical link between the proximal and distal carpal rows. A fall onto an outstretched, extended wrist can load it across its waist, the commonest fracture site, but the distal pole, proximal pole and tuberosity can also be injured. The fracture location and stability matter more than the mechanism alone.
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