The scaphoid bridges the proximal and distal carpal rows, making it the mechanical pivot of wrist motion and uniquely vulnerable to fracture from a fall on the outstretched hand. Its blood supply enters exclusively through its distal pole (from the radial artery via the dorsal scaphoid branch), making the proximal pole avascular. Proximal pole fractures have a 30-40% AVN rate. The waist is the most common fracture site (70%).
An expanded entry for Scaphoid.
| Articulations |
|
|---|---|
| Landmarks |
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| Ossification | Ossification centre appears at 5-6 years. |
Anatomical snuffbox tenderness after FOOSH requires scaphoid fracture protocol: plain X-ray (misses 20-30%), CT or MRI within 72 hours if X-ray negative. Waist fractures in young patients are fixed with a headless compression screw (percutaneous or open). Proximal pole fractures and delayed presentations (>4 weeks) require ORIF with bone grafting. Non-union produces SNAC wrist arthritis.
The most common carpal fracture, from a fall onto an outstretched hand; proximal fractures risk non-union and avascular necrosis.
Tearing of the ligament between scaphoid and lunate causes dorsal wrist pain and can progress to scapholunate advanced collapse.
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