The scaphoid is the largest proximal carpal bone and the most commonly fractured wrist bone, lying at the base of the anatomical snuffbox and bridging the proximal and distal carpal rows. Its tenuous blood supply makes fractures prone to avascular necrosis.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | Endochondral ossification from a single centre appearing between ages 5 and 6, the last carpal bone to ossify. |
The scaphoid is the most commonly fractured carpal bone (70 percent of carpal fractures) and its blood supply enters distally, making the proximal pole vulnerable to avascular necrosis after fractures through the waist. Scaphoid fractures are notorious for being missed on initial radiographs. 20 to 30 percent are invisible acutely, and MRI is the gold standard for detecting occult fractures. Non-union from missed or displaced fractures leads to the scaphoid non-union advanced collapse (SNAC) pattern of wrist arthritis.
The most common carpal fracture, from a fall onto an outstretched hand, with tenderness in the anatomical snuffbox; waist and proximal pole fractures risk non-union and avascular necrosis.
An ununited scaphoid fracture leads to a progressive pattern of wrist arthritis over years.
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