TO TOE) Scaphoid fracture

TO TOE) Scaphoid fracture

The blood supply to the scaphoid enters distally and supplies the scaphoid in a retrograde fashion. As such, a displaced waist of scaphoid fracture interrupts the blood supply to the proximal pole, leading to avascular necrosis. An undisplaced fracture of the scaphoid may not be visible on the initial radiographs. If a fracture is not evident on the initial radiographs and the patient is tender in the anatomical snu ff box following a fall on the outstretched hand, special scaphoid view radiographs should be requested ( Figure 32.21 ). If a fracture is not evident on the initial radiographs and the patient remains tender in the anatomical snu ff box, then treat as a suspected scaphoid fracture until a fracture is actively excluded. The standard pr otocol of a suspected scaphoid frac ture is to immobilise the wrist and examine again 10–14 days later. If tenderness remains, repeat the scaphoid views. If facili ties and resources allow , an earlier diagnosis ma y be made with a bone scan, MRI or CT . Undisplaced fractures can be treated non-operatively in a below-elbow cast. It is not necessary to include the thumb as a routine. In displaced or unstable fractures (>1 /uni00A0 mm) consid eration should be given to open r eduction and rigid fixation with a headless compression screw . Complications of scaphoid fractures include: non-union, avascular necrosis, malunion and carpal instability . TO TOE) Scaphoid fracture

The blood supply to the scaphoid enters distally and supplies the scaphoid in a retrograde fashion. As such, a displaced waist of scaphoid fracture interrupts the blood supply to the proximal pole, leading to avascular necrosis. An undisplaced fracture of the scaphoid may not be visible on the initial radiographs. If a fracture is not evident on the initial radiographs and the patient is tender in the anatomical snu ff box following a fall on the outstretched hand, special scaphoid view radiographs should be requested ( Figure 32.21 ). If a fracture is not evident on the initial radiographs and the patient remains tender in the anatomical snu ff box, then treat as a suspected scaphoid fracture until a fracture is actively excluded. The standard pr otocol of a suspected scaphoid frac ture is to immobilise the wrist and examine again 10–14 days later. If tenderness remains, repeat the scaphoid views. If facili ties and resources allow , an earlier diagnosis ma y be made with a bone scan, MRI or CT . Undisplaced fractures can be treated non-operatively in a below-elbow cast. It is not necessary to include the thumb as a routine. In displaced or unstable fractures (>1 /uni00A0 mm) consid eration should be given to open r eduction and rigid fixation with a headless compression screw . Complications of scaphoid fractures include: non-union, avascular necrosis, malunion and carpal instability . TO TOE) Scaphoid fracture

The blood supply to the scaphoid enters distally and supplies the scaphoid in a retrograde fashion. As such, a displaced waist of scaphoid fracture interrupts the blood supply to the proximal pole, leading to avascular necrosis. An undisplaced fracture of the scaphoid may not be visible on the initial radiographs. If a fracture is not evident on the initial radiographs and the patient is tender in the anatomical snu ff box following a fall on the outstretched hand, special scaphoid view radiographs should be requested ( Figure 32.21 ). If a fracture is not evident on the initial radiographs and the patient remains tender in the anatomical snu ff box, then treat as a suspected scaphoid fracture until a fracture is actively excluded. The standard pr otocol of a suspected scaphoid frac ture is to immobilise the wrist and examine again 10–14 days later. If tenderness remains, repeat the scaphoid views. If facili ties and resources allow , an earlier diagnosis ma y be made with a bone scan, MRI or CT . Undisplaced fractures can be treated non-operatively in a below-elbow cast. It is not necessary to include the thumb as a routine. In displaced or unstable fractures (>1 /uni00A0 mm) consid eration should be given to open r eduction and rigid fixation with a headless compression screw . Complications of scaphoid fractures include: non-union, avascular necrosis, malunion and carpal instability .