Scaphoid fracture and nonunion

Abstract

Scaphoid fractures, which involve approximately two-thirds of all wrist injuries, are often not detected during initial radiographic examination. By using high-resolution CT and dedicated MRI, it is possible to recognize scaphoid fractures soon at the first diagnostic approach and to assess fragment stability. CT imaging provides all the relevant information of the fracture extent and of the fracture healing in the follow-up. MRI is most sensitive in the detection of scaphoid fractures; however, fracture signs must be differentiated from those of a bone bruise. Both the initially overseen scaphoid fracture and the unsuccessful healing can lead to the natural history of scaphoid nonunion. In the injured scaphoid, CT imaging is essential for depicting the osseous morphology, whereas contrast-enhanced MRI is crucial for assessing the viability of the proximal fragment.

Diagnostic imaging of suspected scaphoid fractures: A literature review

“…Avascular necrosis, mal-union or non-union can complicate scaphoid fractures [4][5][6] . The major blood supply to the scaphoid bone enters through the posterior ridge at the middle of the bone and the volar tubercle at the far end of the scaphoid.…”