Abstract
Introduction : Avascular necrosis (AVN) is a frequent complication of scaphoid fractures especially those involving the proximal segment of the bone. This has been attributed to its precarious blood supply which is further compromised by the fracture and surgery. Knowledge of the distribution of scaphoid nutrient foramina, which show variation across populations, is thus important in estimating the risk of vascular damage during surgical approaches and hence the likelihood of AVN. It may also be useful in determining techniques to mitigate this risk. The purpose of this study was to describe the distribution of scaphoid nutrient foramina in adult Kenyans. Methods : One hundred and four human scaphoids were studied. Each was divided into 3 segments: proximal, middle and distal, and the nutrient foramina in each segment counted and categorized into type I (no foramina), type II (1-2 foramina) and type III (>2 foramina). The number of nutrient foramina on the dorsal and volar aspects of the bone was also compared. Results : Type I nutrient foramina were most common (54%) in the proximal segment of the bone while the middle and distal segments had predominantly type III and type II foramina respectively. More foramina were present on the dorsal aspect with a dorsal-volar ratio of 4.23:1. Conclusion : The dorsal approach may result in more damage to nutrient foramina heightening the risk of avascular necrosis. Non-unions in the proximal segment may require vascularized bone grafts. Keywords : Scaphoid, Nutrient Foramina, Non Union, Avascular Necrosis
Highlights
Avascular necrosis (AVN) is a frequent complication of scaphoid fractures especially those involving the proximal segment of the bone
AVN has been reported to occur in 13 to 50% of scaphoid fractures, with an even higher incidence in those involving the proximal segment of the bone [4, 6]
Type I nutrient foramina were the most common (54%) with type III nutrient foramina being prevalent in the middle segment (51%)
Summary
Avascular necrosis (AVN) is a frequent complication of scaphoid fractures especially those involving the proximal segment of the bone. This has been attributed to its precarious blood supply which is further compromised by the fracture and surgery. Knowledge of the distribution of scaphoid nutrient foramina, which show variation across populations, is important in estimating the risk of vascular damage during surgical approaches and the likelihood of AVN. It may be useful in determining techniques to mitigate this risk. Each was divided into 3 segments: proximal, middle and distal, and the nutrient foramina in each segment counted and categorized into type I (no foramina), Introduction
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
