Scaphoid Fracture Flashcards
Which is the most common carpal bone to be fractured
Scaphoid
What are the three parts of the scaphoid
Proximal pole
Waist pole
Distal pole
The branches of which artery supply the scaphoid
Radial artery
which branch of the radial artery supplies 80% of the scaphoid
Dorsal branch of the radial artery
What are the clinical features of a scaphoid fracture
History of high energy trauma
Sudden onset wrist pain
Tenderness in the floor of the anatomical snuff box
Pain on telescoping the thumb
Pain on palpating the scaphoid tubercle
What are the borders of the anatomical snuff box
Laterally - abductor pollicis longus and extensor pollicis brevis
Medially - extensor pollicis longus
What are the contents of the anatomical snuff box
Radial artery
superficial radial nerve
cephalic vein
What are the differential diagnosis
Distal radius fracture
Alt carpal bone fracture
UCL injury
De Quervains tenosynovitis.
What investigations need to be carried out
X rays - scaphoid series - AP, Lateral, oblique
What do you do if initial X ray is negative however symptoms point toward scaphoid fracture
Wrist should be immobilised in a thumb splint and repeat x ray in 10-14 days
what would you do if repeat X ray is negative and symptoms still present
MRI scan of wrist
How would you manage a undisplaced scaphoid fracture
Strict immobilisation in a plaster with a thumb spica splint however surgery may be needed as has a risk of AVN
How would you manage a displaced scaphoid fracture
Surgical - percutaneous variable-pitched screw
What are the complications of a scaphoid fracture
AVN
Non-union
