Wrist Pathology
A 32-year-old man presents with chronic wrist pain 2 years after a fall onto his outstretched hand. He did not seek treatment initially. Examination reveals tenderness in the anatomical snuffbox with reduced wrist range of motion. Radiographs show a scaphoid waist nonunion with cystic changes, sclerotic bone ends, and a humpback deformity. There are early degenerative changes at the radial styloid but no scapholunate advanced collapse pattern. MRI suggests AVN of the proximal pole. Regarding scaphoid nonunion:
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Scaphoid nonunion occurs in 5-15% of fractures due to precarious blood supply (entering distally), i...
SNAC wrist progresses in stages: Stage I (radial styloid arthritis), Stage II (scaphoid fossa of rad...
Scaphoid nonunion is rare (less than 1%); the blood supply enters proximally; SNAC arthritis affects...
Treatment depends on vascularity and arthritis: for viable bone without arthritis, open reduction wi...
For SNAC wrist with arthritis, salvage procedures depend on stage: radial styloidectomy for Stage I,...
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