The Orthobullets Podcast Foundations⎪Hand⎪Scaphoid Fracture
Apr 12, 2025
Learn all about scaphoid fractures, the most frequent injuries among carpal bones, often resulting from falls on an outstretched hand. The podcast dives into their symptoms, epidemiology, and the best imaging practices. Explore both non-operative and operative treatment options, along with real-life clinical scenarios to illustrate key points. Whether you're an orthopaedic resident or a primary care provider, this foundational knowledge is essential for effectively managing these common injuries.
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Scaphoid Fracture Locations
- Scaphoid fractures most commonly involve the waist (65%), followed by the proximal third (25%), then the distal third (10%).
- In children, distal pole fractures were historically most common due to ossification sequence but waist fractures are now predominant.
Unique Scaphoid Blood Supply
- The scaphoid receives blood mainly from the dorsal carpal branch of the radial artery via retrograde flow to the proximal 80%.
- This unique blood supply causes a vascular watershed area, contributing to poor fracture healing, especially proximally.
Imaging Protocol for Diagnosis
- Obtain neutral PA, lateral, semi-pronated oblique, and a scaphoid view with 20-degree ulnar deviation for diagnosis.
- If initial X-rays are negative but suspicion is high, repeat radiographs in 14 to 21 days.