. . PEARLS re SCAPHOID ( NAVICULAR ) FRACTURE :
· Mechanism of injury is fall on outstretched hand.
· Clinical suspect if tenderness of “anatomic snuff box”.
· If suspected, ask for special scaphoid view. Illustration 75.
· If the initial radiograph negative, repeat X-Ray in one week( if suspicious clinically).
· Be aware that the scaphoid has poor vascular supply and the missed fracture might result in avascular necrosis and subsequent chronic pain and limited range of motion of the wrist.
· The missed scaphoid fracture is common in the malpractice case.
Illustration 74 B Scaphoid Fracture
. . PEARL If you remain concerned because of clinical findings—
…..consider CT scan or
….. repeat plain film in 1 week ( this repeat film might then reveal a healing fracture ) or
….. get a scaphoid view. This is a special view with a focus on the broad surface of the scaphoid bone. .
See Illustration 75 for a scaphoid view of this same patient.