![]() ![]() Three common classifications used for scaphoid fracture include the Mayo classification, the Russe classification, and the Herbert classification. 5, 8, 9 It is for this reason that diagnosis and appropriate treatment of the acute fracture, and the possible sequelae of nonunion, is essential.Ĭlassification of scaphoid fractures has been well described in the literature. Nonunion may occur (in 5%–10% of all cases, with an even higher incidence in displaced fractures), and numerous series document progression of nonunion to collapse and arthritis. This tenuous blood supply can result in a protracted healing process after fracture, with the average time to healing of an acute proximal pole fracture averaging 3–6 months. 6, 7 The proximal pole, therefore, is dependent entirely on intraosseous blood flow. 4 Other branches provide 20%–30% of the blood flow and appear from the distal palmar area of the scaphoid, arising either directly from the radial artery or from the superficial palmar branch. 4, 6 Subsequently, these vessels divide and run proximally and palmarly to supply the proximal pole of the scaphoid. The blood supply of the scaphoid is primarily from the radial artery via the artery to the dorsal ridge of the scaphoid, whose branches enter the scaphoid via foramina at the dorsal ridge at the level of the waist of the scaphoid. Osteonecrosis is said to occur in 13%–50% of cases of fracture of the scaphoid, and the incidence of osteonecrosis is even higher in those with involvement of the proximal one-fifth of the scaphoid. 1, 2 Because fractures may disturb the scaphoid’s tenuous blood supply, the healing process may be compromised. Scaphoid fractures are commonly seen in young, healthy individuals and may occur as a result of a fall on the outstretched arm or a forced dorsiflexion injury of the wrist. ![]()
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