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OrthoVellum

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Hand & Upper Limb
intermediate
X-Type

Scaphoid Nonunion

Carpal Pathology

A 28-year-old man presents with chronic radial wrist pain that began after a fall 18 months ago for which he did not seek treatment. Examination reveals snuffbox tenderness and limited wrist motion. Radiographs show a scaphoid waist nonunion with cystic changes, a "humpback" deformity, and early radioscaphoid arthritis. Lateral view demonstrates DISI (dorsal intercalated segment instability) with a scapholunate angle of 75 degrees. Regarding scaphoid nonunion:

Mark each as TRUE or FALSE

A

Scaphoid nonunion occurs when fracture healing fails to progress after adequate time (typically defi...

B

Natural history of untreated nonunion is progressive carpal collapse and arthritis (SNAC wrist - Sca...

C

All scaphoid nonunions heal with prolonged casting; proximal pole fractures have the best blood supp...

D

DISI (dorsal intercalated segment instability) occurs because the scaphoid normally links the proxim...

E

Treatment depends on vascularity and deformity: non-vascularized bone graft (Russe, wedge graft) for...

Answer the questions to see explanations

Click T (True) or F (False) for each option