Rowan CH, Downing ND. BMJ Case Rep 2017. doi:10.1136/bcr-2017-221041 Description Perilunate dislocations are uncommon high-energy injuries which are missed in approximately 25% of cases on initial presentation. We present the X-rays of a 25-year-old man who fell from a height of approximately 2 metres onto an extended wrist. Plain radiographs (figure 1) show classical signs of a trans-scaphoid ...

Twenty observers reported independently on the presence or absence of a fracture of the scaphoid on 60 sets of radiographs; these included initial and 2- to 3-week views in patients in whom the outcome was known, normal scaphoids and random copies of these. Analysis of variance of the accuracy of observations revealed that the 2- to 3-week radiographs did not improve diagnostic ability and that...

Isolated dislocation of the carpal scaphoid is a rare injury. Such dislocation is extremely rare. In this article the authors report a twenty-eight-year-old man with isolated dislocation of the scaphoid with associating radial styloid fracture. We manage the patient with open reduction and Kirschner wire fixation. One year later there is a good functional and radiographic result.

  Background: The I-Space is a radiological imaging system in which Computed Tomography (CT)-scans can be evaluated as a three dimensional hologram. The aim of this study is to analyze the value of virtual reality (I-Space) in diagnosing acute occult scaphoid fractures.   Methods: A convenient cohort of 24 patients with a CT-scan from prior studies, without a scaphoid fracture on radiograph, ye...

AIM To characterise current management of adult patients with possible occult scaphoid fracture in Australasian emergency departments. METHODS Internet-based survey of Directors of Emergency Medicine Training throughout Australasia. Data collected included the most common management used in ED for patients with possible occult scaphoid fracture and whether there was a guideline regarding mana...

The scaphoid is the most commonly fractured bone in the carpus. Although greater than 90% of scaphoid fractures unite with cast immobilization, failure to heal remains a clinical reality, particularly when the fracture is displaced or associated with intracarpal instability [1–3]. Dabezies [4] reported a 55% incidence of nonunion and a 50% rate of proximal pole avascular necrosis (AVN) in scaph...

Whereas avascular necrosis of the scaphoid after a fracture is well-documented, idiopathic avascular necrosis of the scaphoid (Preiser's disease) is rare. Little is known of the aetiology of the condition and even less about the best course of management. We describe a rare case of bilateral Preiser's disease. Possible aetiological factors and a summary of the current concepts of management are...

Trans-scaphoid, trans-radial styloid, trans-triquetral perilunate fracture dislocations are rare. We describe a 19-year-old male who suffered this injury after crashing his bicycle. He underwent open reduction internal fixation and percutaneous pinning. Scaphoid union was achieved at 8 weeks. Near complete range of painless motion was achieved by 4 months.

We studied 45 patients with 46 fractures of the scaphoid who presented sequentially over a period of 21 months. MRI enabled us to relate the pattern of the fracture to the blood supply of the scaphoid. Serial MRI studies of the four main patterns showed that each followed a constant sequence during healing and failure to progress normally predicted nonunion.

If neglected or misdiagnosed, non-union of a scaphoid fracture will almost inevitably progress to radiographic and symptomatic osteoarthritis of the wrist with subsequent morbidity and lifelong disability, especially in young males in which the fracture is more common. Fractures of the scaphoid bone are the most common fractures of the carpus and second in occurrence among fractures of the wris...