Scaphoid pain1/13/2024 ![]() Eighty percent of the scaphoid is covered with cartilage, such that most fractures of the scaphoid bone will extend into some joint.Ī scaphoid fracture is a common, career-threatening wrist injury that has been seen in virtually every sport.Ī scaphoid fracture is any break or crack in the scaphoid. The scaphoid is shaped like a twisted peanut and is only about 1 inch long or a little shorter. Its blood supply comes mostly from the far (distal) end instead of the near (proximal) end. The scaphoid doesn’t have a great blood supply, which is one of the reasons that the scaphoid fracture sometimes doesn’t heal. The scaphoid plays a critical role in maintaining the normal, pain-free motion of the wrist that is required with many athletic activities. This depression is called the “anatomic snuffbox.” If you press with your finger deep into the floor of the anatomic snuffbox, you can barely feel the scaphoid. If you put your thumb up in the air (like a hitchhiker) you will make a small depression at the base of your thumb. It is located in the thumb side of the wrist. The scaphoid is the most commonly fractured wrist (“carpal”) bone. These bones are connected by ligaments, making the wrist a fairly complex joint. There are 8 carpal bones: the scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezoid, and trapezium. The wrist is a complex joint that is composed of the end of the radius (the big bone in the forearm, on the thumb side), the ulna (the small bone in the forearm, on the small finger side) as well as the carpal bones. Offer to move things around to assist in positioning - simple things like lowering/raising the table can go a long way and result in a better experience for the patient. It is important to remember this when examining your patient, as it is easy to forget that simply lifting your hand up and placing it on an image receptor could result in substantial pain.The scaphoid is a small bone in the wrist on the thumb side. More often than not, the pain has not been addressed yet. Ulnar deviation is necessary as it moves the scaphoid away from the radius and rotates it in the palmer aspect, minimizing superimposition and achieving a pure PA projection 1-3. Patients with a fractured scaphoid will be in a lot of pain so deviating their hand to the ulna can be quite a task only deviate the hand as much as the patient can bear it. In a follow-up radiograph, coning down to the scaphoid is favored. concavity of the metacarpal shafts is equal 2Īs scaphoid fractures are associated with FOOSH injuries, it is desirable in the acute setting to collimate to include the wrist in the PA view, covering all areas around the scaphoid that could be the source of pain.articulation between the distal radius and the ulna is open or has little superimposition.minor superimposition of the metacarpal bases.hand is in ulnar deviation with little superimposition over the scaphoid bone.proximal to the include one-quarter of the distal radius and ulna.distal to the midway up the metacarpals.the wrist and elbow should be at shoulder height which makes radius and ulna parallel (lowering the arm makes radius cross the ulna and thus relative shortening of radius).shoulder, elbow, and wrist should all be in the transverse plane, perpendicular to the central beam.the affected hand is placed, palm down on the image receptor with hand in ulnar deviation (see practical points).the affected arm if possible is flexed at 90° so the arm and wrist can rest on the table. ![]() This view aims to show the scaphoid in its anatomical position, hence allowing the visualization of any subtle distal, middle or proximal fractures 1 of the scaphoid. ![]()
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