Whilst immobilisation of scaphoid fractures has traditionally been in a thumb spica, there is good evidence to show that immobilisation of the wrist alone in a short-arm cast is just as effective in promoting union and preventing avascular necrosis. Mismanaged fractures can cause malunion and necrosis to the proximal end of the bone and in turn cause instability of the wrist joint. As such, fractures to this area or more proximally can cause poor outcomes if not managed appropriately. Approximately 75% of the arterial supply is from branches of the radial artery through vascular perforations on the dorsal surface near the tubercle and waist.Īs vascular supply to the proximal pole is mainly retrograde, a fracture through the waist places the proximal pole at risk of avascular necrosis. Scaphoid fractures are much more common in adolescents than younger children. The scaphoid begins ossification around the 4th year of age and may be earlier in females than males. The Scaphoid bone is one of 8 carpal bones in the wrist. What are the potential complications associated with this injury?.What is the usual ED management for this fracture?.Do I need to refer to orthopaedics now?.When is reduction (non-operative and operative) required?.What radiological investigations should be ordered?.How common are they and how do they occur?.
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