Clinical Significance
The scaphoid can be slow to heal because of the limited circulation to the bone. It receives its blood supply primarily from lateral and distal branches of the radial artery. Fortunately, it is relatively difficult to break, but is the most commonly fractured bone in the carpus, particularly because of its unique anatomy and position within the wrist. Approximately 60% of carpal fractures are scaphoid fractures.
The scaphoid primarily receives its blood from the distal end. Failure to heal of the fracture ( non union ) will lead to post traumatic osteoarthritis of the carpus. Healing of the fracture with a non anatomic deformity ( frequently a volar flexed "humpback" ) can also lead to post traumatic arthritis . Non unions can result in loss of blood supply to the proximal pole which can result in avascular necrosis of the proximal segment.
A condition called scapholunate instability can occur when the scapholunate ligament (connecting the scaphoid to the lunate bone) and other surrounding ligaments are disrupted.
Fractures of the scaphoid must be recognized and treated quickly, as prompt treatment by immobilization or surgical fixation increases the likelihood of healing in anatomic alignment avoiding mal union or non union. Delays may compromise healing. Even rapidly immobilized fractures may require surgical treatment, including use of a headless compression screw such as the Herbert screw to bind the two halves together.
Read more about this topic: Scaphoid Bone
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