Scaphoid fracture: Difference between revisions
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Scaphoid Fractures can be classed as Scaphoid Tubercle Fractures, Scaphoid Waist Fractures, and Scaphoid Proximal-Pole Fractures. |
Scaphoid Fractures can be classed as Scaphoid Tubercle Fractures, Scaphoid Waist Fractures, and Scaphoid Proximal-Pole Fractures. |
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Scaphoid is '''Greek for "Canoe" Or "Boat"'''; The Scahpoid actually resembles a bent and twisted boat. |
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==Scaphoid Fractures Associated With Transscaphoid Perilunate Fracture-Dislocations== |
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When the hand is outstretched and the wrist is in ulnar deviation, the scaphoid is vertically aligned. The axial load combined with normal palmar curvature of the scaphoid results in a bending movement that collapses the scaphoid. The fracture can invole the scaphoid wrist, proximal pole, or the tubercle; waist fractures are the type most commonly associated with transscaphoid perilunate fracture-dislocations. Proximal-pole fractures have the poorest prognosis because the blood supply to the proximal pole is disrupted by the facture. In these injuries it is important to identify whether or not the fracture is comminuted because such fractures may require bone grafting with internal fixation, requring a different surgical approach. As mentioned, trispiral CT is currently the most reliable means of assessing fracture configuration and amount of comminution. Understanding Scaphoid anatomy is essential for treating transscaphoid perilunate injuries. Scaphoid is '''Greek for "Canoe" Or "Boat"'''; the scahpoid actually resembles a bent and twisted boat. The plane of the scaphoid, which is 45o of the palmar tilt to the longitudinal axis of the forearm and 45o radial angulation from the central axis of the forearm on the PA projection, often deceives surgeons. The entire proximal half of the scaphoid is an articular surface within the radiocarpal joint, so blood supply can enter only on the distal palmar segments and dorsal ridges. Vessels entering the dorsal ridge of the scaphoid arise directly from the radial artery and supply 70% to 80% of the bone, including the proximal pole. For this reason, proximal-pole fractures require the longest time to union (As long as 10 months) and are associated with a high incidence of osteonecrosis (Approaching 50%). Approximately one third of patients have no perforating vessels proximal to the scaphoid waist. |
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==External Websites== |
==External Websites== |
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Revision as of 05:40, 21 February 2009
Scaphoid Fracture
Scaphoid Fractures can be classed as Scaphoid Tubercle Fractures, Scaphoid Waist Fractures, and Scaphoid Proximal-Pole Fractures.
Scaphoid is Greek for "Canoe" Or "Boat"; The Scahpoid actually resembles a bent and twisted boat.
External Websites
http://www.wheelessonline.com/ortho/scaphoid_scaphoid_fracture