Scaphoid Fractures Flashcards
What is a scaphoid fracture?
It is defined as a wrist fracture involving the scaphoid carpal bone
What is the most commonly fracture carpal bone?
Scaphoid
What is the mechanism of injury associated with scaphoid fractures?
A fall on an ulnar deviated, pronated and hyperdorsifexed (outstretched) wrist
What three risk factors are associated with scaphoid fractures?
Young Age, 15 – 29 Years Old
Male Gender
Contact Sports
What are the four clincial features of scaphoid fractures?
Deep Dull Radial Wrist Pain
Wrist Joint Effusion
Decreased Wrist Movement
Decreased Grip/Pinch Strength
Describe the pain associated with scaphoid fractures
The pain is located in the anatomical snuffbox dorsally or scaphoid tubercle volarly
The pain is elicted by telescoping of the thumb, which is longitudinal compression
Where is the anatomical snuffbox located?
It is located between the extensor pollicis longus and the extensor pollicis brevis tendons
What two investigations are used to diagnose scaphoid fractures?
Wrist X-Ray
MRI Scans
Which four x-ray views should be requested in order to diagnose scaphoid fractures?
Anterior-Posterior View
Lateral View
Oblique View
Scaphoid View
What two features indicate scaphoid fractures on wrist x-rays?
Lucent Line Of Scaphoid
Wrist Soft Tissue Swelling
What is important to note about the use of wrist x-rays in order to diagnsoe scaphoid fractures?
The initial wrist x-ray scan may result in the presentation of normal results
Therefore, diagnosis should not be excluded until further imaging is conducted
What is the gold standard investigation used to diagnose scaphoid fractures?
MRI Scans
What is the feature of scaphoid fractures on MRI scans?
Scaphoid bone signal changes
What is the most appropriate management step in cases of suspected scaphoid fractures, with inconclusive imaging?
There should be further imaging and a clinical review 7 – 10 days after injury
What are the three immediate management options of scaphoid fractures?
ABCDE Assessment
Analgesia
Wrist Immobilisation
What two splints are used to immediatley immobilise scaphoid fractures?
Futuro splint
Standard below-elbow backslab
What is the non-surgical management option of scaphoid fractures?
Immobilisation Cast
When is an immobilisation cast used to manage scaphoid fractures?
Undisplaced fractures of the scaphoid waist
How long are immobilisation casts used to manage scaphoid fractures?
6 - 8 weeks
What is the surgical management option of scaphoid fractures?
Wrist Fixation
When is wrist fixation used to manage scaphoid fractures?
It is used to manage displaced and proximal pole scaphoid fractures
What are the four complications associated with scaphoid fractures?
Non-Union
Avascular Necrosis
Scapholunate Dissociation
Osteoarthritis
What is the neovascular structure mainly compromised in scaphoid fractures?
The dorsal carpal branch of the radial artery
What is the clinical feature of avascular necrosis?
Gradual worsening of pain in the affected wrist - sometimes years after the injury
