Abstract
The scaphoid is the most commonly fractured carpal bone, with frequent complications
that are predisposed by its anatomical location, anatomical configuration (shape and
length), and vascular supply. The most common mechanism of injury is a fall onto an
outstretched hand. Imaging plays a significant role in the initial evaluation and
treatment of scaphoid fractures and their complications. Radiography should be the
first imaging modality in the initial evaluation and follow-up of scaphoid fractures.
Computed tomography with its superb spatial resolution enables better visualization
and characterization of the fracture line, and the amount of displacement and angulation
of the fracture fragments. Using the metal reduction artifact with computed tomography
allows good follow-up of scaphoid fractures despite surgical hardware. Magnetic resonance
imaging without contrast is the imaging modality of choice for depiction of radiographically
occult scaphoid fracture, bone contusion, and associated soft tissue injury; contrast-enhanced
imaging aids assessment of scaphoid fracture nonunion, osteonecrosis, fracture healing
after bone grafting, and revitalization of the necrotic bone after bone grafting.
Proper identification and classification of scaphoid fracture and its complications
is necessary for appropriate treatment. This article describes the normal anatomy,
mechanism of injury, and classification of stable and unstable fractures, together
with the imaging and treatment algorithm of scaphoid fractures and their complications
with an emphasis on magnetic resonance imaging.
Keywords
scaphoid - fracture - nonunion - osteonecrosis - radiography - MRI - CT - treatment
