Podcast
Questions and Answers
Pain in anatomical ______ and on directed palpation of scaphoid
Pain in anatomical ______ and on directed palpation of scaphoid
snuffbox
If you suspect scaphoid fracture, send them in for ______ ASAP
If you suspect scaphoid fracture, send them in for ______ ASAP
X-ray
If fracture is more ______, will increase time in cast
If fracture is more ______, will increase time in cast
proximal
Recent research shows union is achieved at ______ weeks for approx 90% of non-displaced fractures
Recent research shows union is achieved at ______ weeks for approx 90% of non-displaced fractures
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Rehab once out of cast includes increasing ______, particularly in pronation & supination
Rehab once out of cast includes increasing ______, particularly in pronation & supination
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After adequate conservative management, ______ is achieved for most non-displaced fractures
After adequate conservative management, ______ is achieved for most non-displaced fractures
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Need to get radiographic imaging before ______ to ensure complete union
Need to get radiographic imaging before ______ to ensure complete union
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If X-ray comes back clear but symptoms persist, send them back after a week/10 ______
If X-ray comes back clear but symptoms persist, send them back after a week/10 ______
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The scaphoid is primarily supplied by the ______ artery.
The scaphoid is primarily supplied by the ______ artery.
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The most common cause of scaphoid fractures is falling onto an ______ hand.
The most common cause of scaphoid fractures is falling onto an ______ hand.
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Fractures can occur in three places: distal pole, proximal pole, or ______.
Fractures can occur in three places: distal pole, proximal pole, or ______.
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Blood supply to the scaphoid can greatly impact ______ time.
Blood supply to the scaphoid can greatly impact ______ time.
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If a fracture extends into the joint, it is referred to as ______-articular.
If a fracture extends into the joint, it is referred to as ______-articular.
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A common scenario for scaphoid fractures includes accidents during ______ dismounts.
A common scenario for scaphoid fractures includes accidents during ______ dismounts.
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The major portion of the scaphoid surface is covered by ______ cartilage.
The major portion of the scaphoid surface is covered by ______ cartilage.
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Fractures at the proximal pole of the scaphoid can lead to delayed ______ due to poor blood supply.
Fractures at the proximal pole of the scaphoid can lead to delayed ______ due to poor blood supply.
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Study Notes
Scaphoid Fractures
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Etiology: Most common cause is a fall onto an outstretched hand (FOOSH). Often associated with activities like contact sports, car accidents, and gymnastics. Fractures can occur at the distal pole, proximal pole, or waist.
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Anatomy: The scaphoid is a carpal bone in the wrist. Its blood supply is limited, particularly to the proximal pole, which can affect healing time.
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Pathophysiology: Limited blood supply from the radial artery. The major part of the scaphoid is covered by articular cartilage with limited soft tissue attachment. Fractures at the proximal pole can significantly prolong healing due to poor vascularity. Delayed healing can increase risk of non-union (the fracture not healing together) and osteonecrosis (bone death).
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Signs and Symptoms: Pain in the anatomical snuffbox (a depression on the wrist), pain during palpation of the scaphoid bone, pain immediately after impact that may progress to a dull ache. Edema, restricted wrist and thumb movement, and impaired hand function.
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Diagnosis: X-rays are often used. However, fractures might not appear on X-ray for up to 10-14 days after the injury. In some cases, delayed or inconclusive X-rays may require further imaging such as an MRI.
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Treatment: Non-displaced fractures usually respond well to casting, immobilization for 6-12 weeks. More severe fractures might require surgery. Surgical interventions might include internal fixation with screws for stabilization.
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Conservative Management: For non-displaced or minimally displaced scaphoid fractures (less than or equal to 0.5mm displacement), 6-weeks of immobilisation might be sufficient for healing. This involves a cast or brace.
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Moderate Displacement: Fractures with a moderate displacement (0.5-1.5mm) might require prolonged immobilisation (8-10 weeks) to allow healing.
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Displaced Fractures: Fractures that show significant displacement are generally treated surgically with internal fixation (surgical placement of screws or pins).
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Rehabilitation: Rehabilitation focuses on decreasing swelling, improving range of motion, and strengthening the wrist and hand after casting or surgery.
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Description
This quiz covers the etiology, anatomy, and pathophysiology of scaphoid fractures. Learn about the most common causes, symptoms, and complications associated with this wrist injury. Test your knowledge on the healing process and anatomical details.
