Wrist scaphoid fracture

Introduction to the scaphoid fracture Wrist bone fractures are more common, and young adults often occur, often caused by indirect violence. Falling palms touched the ground, the wrist strength dorsiflexion, slight deviation, the back side of the humerus cut off the scaphoid. Local swelling, pain, limited wrist activity and increased pain after injury. basic knowledge The proportion of illness: 0.03%--0.055% Susceptible people: more in young adults Mode of infection: non-infectious Complications: osteonecrosis

Cause of scaphoid fracture

This disease is often caused by indirect violence. Falling palms touched the ground, the wrist strength dorsiflexion, slight deviation, the back side of the humerus cut off the scaphoid.

Indirect violence: Fractures occur in areas that are far from violent, and do not occur where violence directly affects. A fracture is caused by violence through conduction, leverage or rotation. For example, the supracondylar fracture of the humerus is due to the fracture of the upper part of the elbow joint above the elbow joint when the wounded person slips and walks with the palm of the hand.

Prevention of wrist scaphoid fracture

There are no special preventive measures for this disease, mainly to avoid trauma as much as possible, and active treatment is needed to prevent complications.

Complications of scaphoid fracture Complications osteonecrosis

When the scaphoid fracture occurs, the blood supply of the proximal scaphoid fracture is blocked, and bone resorption and necrosis are easy to occur, resulting in delayed fracture healing or non-union.

1. Freshly displaced unstable fractures with a displacement of more than 1 mm are considered to be displaced and unstable scaphoid fractures, because such fractures are usually accompanied by ligament and blood vessel damage, and the risk of complications is high. Surgical treatment.

2, nonunion due to the anatomical features of the scaphoid bone and its adjacent relationship, easy to miss the diagnosis after fracture and improper treatment and reset fixation, often delayed fracture healing or nonunion.

3. The incidence of avascular necrosis of the scaphoid is closely related to the degree of fracture and displacement. The rate of ischemic necrosis of the distal mass of the lumbar fracture is more than 30%, and the rate of ischemic necrosis of the proximal fracture is almost 100%. .

Symptoms of scaphoid fractures Common symptoms Joint pain Simple fractures Joint swelling Wrist gun stab deformity

Local swelling, pain, limited wrist movement and increased pain, tenderness at the nasopharyngeal fossa and scaphoid nodules, and longitudinal sputum pain in the 2nd and 3rd metacarpal heads.

Examination of the scaphoid fracture

The examination of this disease mainly includes comprehensive physical examination and X-ray examination.

1, comprehensive physical examination attention to whether there is shock, soft tissue injury, bleeding, check the size of the wound, shape, depth and pollution, with or without bone end exposure, with or without nerves, blood vessels, craniocerebral, visceral injuries and other parts of the fracture, to serious The wounded must be carried out quickly.

2, the test method of the scaphoid movement test: the patient's wrist joint is passively biased, the examiner holds the wrist of the patient with one hand, presses the scaphoid nodule with the thumb, and holds the palm of the patient with the other hand to make the wrist joint Gradually turn to the temporal side, and feel that the wrist is severely painful and positive.

3, X-ray examination in addition to positive, lateral X-ray film, should also be based on the injury to shoot a special body phase, such as the opening position (upper cervical spine injury), dynamic lateral position (cervical vertebra), axial position (scapular bone, Trachea, etc., and tangential position (tibia), complex pelvic fractures or suspected intraspinal fractures, should be considered as a slice or CT examination.

Diagnosis and diagnosis of scaphoid fracture

diagnosis

1. Ask about the injury, including the cause of the injury, time, location, body posture and where the injury occurred first. If there is a wound or bleeding, you should also ask if the wound has been treated, whether the tourniquet has been used and the time of the tourniquet has been used.

2, comprehensive physical examination attention to whether there is shock, soft tissue injury, bleeding, check the size, shape, depth and pollution of the wound, with or without bone end exposure, with or without nerves, blood vessels, craniocerebral, visceral injuries and other parts of the fracture, to serious The wounded must be carried out quickly.

3, X-ray examination in addition to positive, lateral X-ray film, should also be based on the injury to shoot a special body phase, such as the opening position (upper cervical spine injury), dynamic lateral position (cervical vertebra), axial position (scapular bone, Trachea, etc., and tangential position (tibia), complex pelvic fractures or suspected intraspinal fractures, should be considered as a slice or CT examination.

Differential diagnosis

Sometimes the symptoms of minor fractures are not obvious, similar to the symptoms of wrist sprains, easy to be misdiagnosed and neglected. The three parts of the wrist can be diagnosed with fractures and directions. If the fracture is unclear and the clinical symptoms are suspected of fracture, the fracture should be temporarily treated. After two weeks, the X-ray was reviewed and the fracture line was clearly recognized due to bone resorption at the fracture site.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.