Since the patient was a regular cricketer and had occasional pain in the wrist for 2 years, this could have been a stress fracture caused due to playing cricket. All these cases went on to heal after a period of immobilisation.Ī cause for the scaphoid fracture could not be identified in this case as there was no history of significant injury to the wrist. The mechanism of a stress fracture of the scaphoid has been postulated as repeated dorsiflexion of the wrist. In a review of literature a stress fracture of the scaphoid has not been reported in a cricketer. These have been previously reported in gymnasts, shotputter, and a badminton player. There are only few cases reported in the literature. 2012 40(9):1791–6.Stress fracture of the scaphoid is a rare yet important condition which if not detected can lead to non-union with secondary osteoarthritis of the wrist, which results in lifelong disability. Vascularized bone grafts for scaphoid nonunions. Scaphoid waist nonunion with humpback deformity treated without structural bone graft. Graft choice in the management of unstable scaphoid nonunion: a systematic review. Pronated oblique view in assessing proximal scaphoid articular cannulated screw penetration. A comparison of 2 methods for scaphoid central screw placement from a volar approach. Correction of lunate malalignment when bone grafting scaphoid nonunion with humpback deformity: rationale and results of a technique revisited. Percutaneous screw fixation for scaphoid fracture: a comparison between the dorsal and the volar approaches. Treatment of scaphoid nonunion: a systematic review of the existing evidence. Pinder RM, Brkljac M, Rix L, Muir L, Brewster M. Associated ligamentous injuries and greater arc transscaphoid perilunate fracture-dislocations also occur but are beyond the scope of this chapter. Vascularized, pedicled rotational bone grafts from the distal radius or microvascular free grafts from the medial femoral condyle may be utilized in complex, chronic non-unions or proximal pole avascular necrosis. This chapter describes in detail the use of non-vascularized cancellous only or structural corticocancellous bone graft with a palmar approach in conjunction with retrograde screw or wire fixation. Retrograde screw placement from a palmar approach is often used for distal third fractures or in chronic non-unions where a significant humpback deformity and/or bone loss is present and bone graft placement is necessary. Antegrade fixation placement through a dorsal approach is often used for acute, displaced proximal pole or waist fractures. volar approach, need for supplemental bone graft, and type of fixation. Diagnostic work-up may include plain radiographs, computerized tomography (CT scan), and magnetic resonance imaging (MRI). Factors that help determine treatment recommendations include presence or absence of arthritis, vascularity of proximal scaphoid, associated ligamentous injuries, time from injury, patient age, activity level, work requirements, smoking status, medical comorbidities, and patient reliability. Thus, chronic scaphoid non-unions are relatively common. They may not be recognized by the patient or health care provider initially. Scaphoid fractures can be a challenging injury to treat.
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