Scaphoid Fractures Blood Supply - Everything You Need To Know - Dr. Nabil Ebraheim

Video Description

Dr. Ebraheim’s educational animated video describes fractures types and blood supply of the scaphoid carpal bone in the hand.
The scaphoid bone is the most common carpal bone to fracture. Fracture of the scaphoid usually occurs from a fall onto an outstretched hand. The patient will present with wrist pain and swelling. The injury maybe mistaken for a wrist sprain.
Look for tenderness in the anatomic “snuffbox”.
The x-ray may be negative.
When a scaphoid fracture is suspected, immobilize the wrist adequately with a thumb spica for a short period of time. Remove the cast after 10 days and re-examine the patient. also, repeat the previously negative x-ray.
Fractures of the scaphoid can be missed. Fractures types:
1-Waste fracture: most frequent fracture site and has moderate risk of AVN and nonunion.
2-Distal pole fracture: AVN is rare.
3-Proximal pole fracture: high incidence nonunion and AVN.
4-Tuberosity fracture
The blood supply of the scaphoid is unrigid and tenuous. Radial artery: volar branch (20-30% of blood supply). Dorsal branch (70-80% of blood supply).
Scaphoid fractures can lead to nonunion and avascular necrosis due to interruption of the blood supply.
Treatment
Acute fracture:
•reduction
•fixation
•compression screw.
Nonunion: two types
1-fibrous
2-sclerotic
treatment
•reduction
•fixation
•bone graft with compression screw.

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