![]() The third radiograph shows a very subtle fracture appearing as a fine, irregular lucency through the waist. The second radiograph shows a fracture appearing as an irregular lucent line through the waist of the scaphoid. The first radiograph below shows a fractured scaphoid appearing as a small break in the cortex. With healing, there is reabsorption of bone along the fracture line, making it more visible at 2 weeks.įractures of the scaphoid bone can be very subtle and even missed on the initial radiograph. If a patient has tenderness in the area of the anatomic snuffbox, but no fracture is apparent on x-ray, he/she should be immobilized in a thumb spica cast and instructed to return for repeat x-rays in 2 weeks. These can lead to chronic pain and instability of the wrist. Failure to recognize and appropriately manage these fractures can result in avascular necrosis of the scaphoid bone and/or non-union of the fracture. If displaced, they require urgent orthopedic consultation for reduction. If undisplaced, these fractures are managed with a thumb spica cast which immobilizes the wrist and the thumb. The scaphoid bone is the most commonly fractured carpal bone, accounting for 50-60% of all carpal injuries. ![]() Note on the oblique radiograph that there is a lucent line representing a fracture through the waist of the scaphoid bone. There was considerable swelling and tenderness in the anatomic snuffbox. This 35 year old female patient fell from her bike and suffered a hyperextension of her wrist.
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