Scaphoid Fractures Overview
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Questions and Answers

Pain in anatomical ______ and on directed palpation of scaphoid

snuffbox

If you suspect scaphoid fracture, send them in for ______ ASAP

X-ray

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

<p>6</p> Signup and view all the answers

Rehab once out of cast includes increasing ______, particularly in pronation & supination

<p>ROM</p> Signup and view all the answers

After adequate conservative management, ______ is achieved for most non-displaced fractures

<p>union</p> Signup and view all the answers

Need to get radiographic imaging before ______ to ensure complete union

<p>RTP</p> Signup and view all the answers

If X-ray comes back clear but symptoms persist, send them back after a week/10 ______

<p>days</p> Signup and view all the answers

The scaphoid is primarily supplied by the ______ artery.

<p>radial</p> Signup and view all the answers

The most common cause of scaphoid fractures is falling onto an ______ hand.

<p>outstretched</p> Signup and view all the answers

Fractures can occur in three places: distal pole, proximal pole, or ______.

<p>waist</p> Signup and view all the answers

Blood supply to the scaphoid can greatly impact ______ time.

<p>healing</p> Signup and view all the answers

If a fracture extends into the joint, it is referred to as ______-articular.

<p>intra</p> Signup and view all the answers

A common scenario for scaphoid fractures includes accidents during ______ dismounts.

<p>gymnastics</p> Signup and view all the answers

The major portion of the scaphoid surface is covered by ______ cartilage.

<p>articular</p> Signup and view all the answers

Fractures at the proximal pole of the scaphoid can lead to delayed ______ due to poor blood supply.

<p>union</p> Signup and view all the answers

Flashcards

Scaphoid Blood Supply

The scaphoid bone is supplied by the radial artery, but the blood supply is limited, especially to the proximal pole.

Scaphoid Fracture Cause

A fall onto an outstretched hand (FOOSH) is the most common cause of scaphoid fractures, especially with a radially deviated wrist.

Scaphoid Fracture Locations

Scaphoid fractures can occur at the distal pole, proximal pole, or waist of the bone.

Proximal Pole Fracture Healing

Because of its limited blood supply, a scaphoid fracture at the proximal pole has a higher risk of delayed union or non-union (failure to heal properly).

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Intra-articular vs. Extra-articular Fractures

Fractures that extend inside the joint (intra-articular) are more complex than fractures outside the joint (extra-articular), as they involve the cartilage surfaces.

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Blood Supply & Healing Time

The blood supply to the scaphoid influences the healing time of a fracture.

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Scaphoid Vascularity

The limited vascularity of the scaphoid, particularly at the proximal pole, is due to it being covered mostly by articular cartilage, which has fewer places for blood vessels to attach.

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Scaphoid Fractures in Sports

Scaphoid fractures can occur in athletes involved in contact sports, such as gymnastics and grappling.

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Scaphoid Fracture

A fracture of the scaphoid bone, often caused by a fall onto an outstretched hand.

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Anatomical Snuffbox

A painful area on the back of the hand at the base of the thumb, often associated with scaphoid fractures.

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Pain After Impact

Initial pain after a fall onto the outstretched hand, which may develop into a dull ache on the radial side.

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Effusion in Anatomical Snuffbox

Fluid buildup within the anatomical snuffbox, often a sign of a scaphoid fracture.

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Limited Thumb/Wrist Extension

Limited ability to extend the thumb and wrist passively and actively.

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Pain with Scaphoid Pressure

Pain with direct pressure on the scaphoid during passive radial deviation (wrist bending towards the thumb side).

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Scaphoid Fracture Fixation

A surgical procedure to fix a scaphoid fracture by attaching screws or pins to stabilize the bone and promote healing.

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Study Notes

Scaphoid Fractures

  • 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.

  • 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.

  • 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).

  • 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.

  • 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.

  • 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.

  • 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.

  • Moderate Displacement: Fractures with a moderate displacement (0.5-1.5mm) might require prolonged immobilisation (8-10 weeks) to allow healing.

  • Displaced Fractures: Fractures that show significant displacement are generally treated surgically with internal fixation (surgical placement of screws or pins).

  • Rehabilitation: Rehabilitation focuses on decreasing swelling, improving range of motion, and strengthening the wrist and hand after casting or surgery.

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Scaphoid Fracture PDF

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.

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