Scaphoid Fracture/Nonunion

Toshiyasu Nakamura

¹Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan

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Scaphoid fractures and scaphoid nonunion are still difficult to treat either conservatively or surgically. As the scaphoid is a strut to keep length and alignment of the proximal carpal row, unstable scaphoid fracture or its nonunion makes the distal scaphoid fragment flex, with rest others (proximal scaphoid, lunate, and triquetrum) extend, and the wrist can no longer keep its length, causing dorsal intercalated segment instability (DISI) deformity, i.e., carpal instability. Once DISI deformity occurs, degenerative changes are noted starting from the radial styloid to radioscaphoid and scaphocapitate joints that are known as the scaphoid nonunion advanced collapse. Also, blood supply of the scaphoid proximal side is quite unstable, and sometimes we see necrosis of the proximal pole after scaphoid waist or proximal fracture. That is why early diagnosis of the scaphoid fracture by computed tomography or magnetic resonance imaging is important, and adequate surgical treatments algorithm is necessary for unstable scaphoid fracture/nonunion, especially in adult.

In this issue, the “Special review” is “Surgical treatment of scaphoid fractures: recommendations for management” by Drs. Samade and Awan. They organized comprehensive reviews of recent literatures about surgical treatment of scaphoid fracture/nonunion and tried to compile recent treatment recommendation algorithm that would be beneficial to our readers. Interesting wrist papers, such as risk factor of displacement of distal radius fracture, triangular fibrocartilage complex tears with extensor carpi ulnaris problems, metacarpophalangeal joint arthroscopy, emerging technology paper, surveys and meta-analysis, interesting case reports are included in this issue. Do not miss them.

Publication History

Article published online:
27 May 2024

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