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Scaphoid Nonunion


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Scaphoid Nonunion

Elliot K. Fishman, MD
Director of Diagnostic Imaging and Body CT, Professor of Radiology and Radiological Science, Johns Hopkins
Karen M. Horton, MD
Professor and Interim Chair, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins

This is a patient who presented with chronic radial sided wrist pain. Radiographs of the wrist were obtained. The frontal radiograph demonstrates an abnormal appearance of the scaphoid. The second and third radiographs are oblique and lateral views which demonstrate a chronic united fracture of the distal pole of the scaphoid, likely from prior trauma. The scaphoid often does not heal following fracture due to its tenuous blood supply which can easily be disrupted following trauma. Ununited scaphoid fractues can predispose patients to a particular kind of osteoarthrosis of the wrist called SNAC wrist, or scaphoid nonunion advanced collapse. The ligaments of the proximal carpal row weaken which allows for proximal migration of the capitate and radioscaphoid osteoarthrosis.