Clinical-Medical Image - International Journal of Clinical & Medical Images (2020) Volume 7, Issue 7
Author(s): Sharat Agarwal*
Scaphoid fractures are prone to non-union because of tenous blood supply, limited soft tissue attachments, lack or periosteum, tension & bending stresses at the scaphoid waist, intra-articular nature compromising union with associated delayed & missed diagnosis during initial evaluation. A male 32 years old patient with FOOSH injury around 11 months back which was managed like a wrist sprain with rest for 2 weeks at the time of injury. He came with complaints of wrist pain on movements & straining of wrist. There was tenderness in anatomical snuff box. Radiography revealed non-union of scaphoid (Figure 1) which was confirmed on CT wrist with no evidence of avascular necrosis (AVN). He was planned with osteosynthesis, interpositional prismoid cancellous bone graft harvested from the volar aspect of distal radius (Figures 2 and 3) for stimulating bone healing and stabilized with using a screw across the fracture successfully (Figures 4 and 5). An immobilization in below elbow Plaster of Paris (PoP) scaphoid cast was given awaiting union and to initiate wrist physiotherapy subsequently to regain wrist function. Thus, rule out scaphoid fracture in before wrongly labelling an injury as wrist strain to avoid complications in future.