These are the options to access the full texts of the publication Revista Española de Cirugía Ortopédica y Traumatología. Subscriber. Subscriber. If you already. En este artículo hemos realizado una actualización de conceptos sobre las fracturas del escafoides carpiano, su diagnóstico, los tipos de fractura y su valor . PDF | On Nov 1, , Luis Nieto and others published Fractura de Escafoides.

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Older patients falling in a similar manner are more likely to sustain a escqfoides radial fracture usually a Colles fracture. The usual mechanism is falling on an outstretched hand with resultant hyper-extension of the wrist or purely compressive force 7. Occasionally stress fractures are also encountered although these are less common, and only usually seen in athletes e.

Fractures can occur essentially anywhere along the scaphoid, but distribution is not even Mayo classification of scaphoid fractures. A dedicated plain radiographic series investigating the scaphoid exists, consisting of four projections of the scaphoid bone. It is positionally different from the wrist series.

If AVN develops the first sign will be slight sclerosis. This can be on account of the rest of the wrist undergoing demineralisation due to immobilisation, whereas the proximal portion being bereft of blood supply retains its calcium. With time the proximal part undergoes osteonecrosis, becomes increasingly sclerotic fraftura can ‘implode’ and fragment with secondary osteoarthritic changes 9.

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In addition to stating that a fracture is present, a number of features should be sought and commented upon:. Importantly if no fracture is seen it is essential to recommend repeat x-rays including dedicated scaphoid views in days 1. If these repeat films are negative also, then MRI or bone scan if MRI is unavailable should be recommended if clinical suspicion persists 1.

CT may be used for diagnosis when plain films are normal because it is readily available and quick CT may be insensitive to trabecular injury 5. CT is useful for staging scaphoid fractures if surgery is considered and when fractures of the carpus are extensive or complex. CT also is useful in assessing bone union 8. MRI is the most sensitive fracyura for trabecular fractures, and this can detect completely undisplaced fractures, especially in the first 24 escaafoides following injury 9, It is also useful in assessing for avascular necrosis.

Although bone scans are more sensitive than plain film, they are usually reserved for patients with ongoing pain despite normal serial plain films 8, Bone scans will be most sensitive days following the injury.

[Four corner fusion in patients with wrist arthritis].

An occult fracture will appear as a region of increased escafoiides, whereas avascular necrosis will demonstrate a photopaenic region at the lower pole of the scaphoid.

The major complication of scaphoid fractures is non-union or malunion leading to instability and secondary osteoarthritic change. Hence surgical treatment of displaced fractures or angulation. The term scaphoid derives from the Greek word for boat.


The bone profile is thought to look like a boat or skiff. To quiz escafoidew on this article, log in to see multiple choice questions.

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Articles Cases Courses Quiz. About Blog Go ad-free. Read it at Google Books – Find it at Amazon. Edit article Share article View revision history. Synonyms or Alternate Spellings: Carpal navicular fracture Scaphoid fractures Carpal navicular fractures Scaphoid bone fractures Scaphoid bone fracture Fracture of scaphoid bone Scaphoid fx.

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[Four corner fusion in patients with wrist arthritis].

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