Scaphoid fractures are the most common carpal bone injury, carrying a notorious risk of avascular necrosis and nonunion. Master the retrograde blood supply, Herbert classificationand acute management decisions in this comprehensive orthopaedic masterclass. ⏱ Chapters 0:00 Intro 0:19 Essentials 0:46 Blood Supply 1:19 Herbert 1:49 Location Risk 2:14 Panda 2:44 Snac 3:11 Occult Algorithm 3:38 Management 4:14 Numbers 4:40 Clinical reasoning — Occult 5:09 Clinical reasoning — Displaced This video provides an in-depth breakdown of scaphoid fractures, covering everything from unique carpal anatomy and the dorsal vascular ridge to the predictable pattern of SNAC wrist arthritic collapse. We explore the Herbert classification system, surgical indications using the PANDA mnemonic, occult fracture imaging trapsand the differences between conservative casting and operative fixation using a headless compression screw. 🦴 IN THIS VIDEO YOU'LL LEARN • The clinical significance of the scaphoid's retrograde blood supply from the dorsal carpal branch of the radial artery • How to apply the Herbert classification to differentiate stable and unstable acute fractures • Why 10-20% of scaphoid fractures are radiographically occult on initial X-rays • The five PANDA indications for operative surgical fixation • How fracture location dictates the risk of avascular necrosis and nonunion • The modern imaging gold standard of immediate MRI for clinically suspected but X-ray negative injuries • The predictable four-stage progression of SNAC (Scaphoid Nonunion Advanced Collapse) wrist • How to identify carpal instability and DISI patterns on lateral wrist radiographs • The principles of bone grafting and vascularised grafts for established scaphoid nonunion ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Proximal pole fractures have the highest risk of avascular necrosis due to their complete reliance on retrograde intraosseous blood flow. ✔️ Anatomic snuffbox tenderness with normal initial radiographs still warrants either immobilisation or an immediate MRI. ✔️ Herbert Type A fractures are stable and managed conservatively, whilst Type B fractures are inherently unstable and require surgical fixation. ✔️ Untreated nonunion predictably leads to SNAC wrist, progressing from the radial styloid to pancarpal arthritis. ✔️ Displacement greater than 1mm or a scapholunate angle over 60 degrees mandates operative intervention. 👩⚕️ WHO THIS IS FOR This masterclass is designed for orthopaedic trainees, junior doctorsand medical students seeking a comprehensive understanding of carpal injuries. It also serves as a highly detailed resource for curious patients wanting to learn more about the science behind scaphoid fracture management. 📚 RELATED TOPICS: Avascular Necrosis of the Proximal Pole · Scaphoid Nonunion Advanced Collapse (SNAC Wrist) · Herbert Screw Fixation Technique · Vascularised Bone Grafting for Scaphoid Nonunion · Perilunate and Trans-scaphoid Dislocations · Carpal Instability and DISI Patterns 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #scaphoidfracture #orthovellum #handtrauma #carpalfracture #avascularnecrosis #herbertclassification #orthopedicsurgery #fooshinjury #snacwrist #bonesurgery #medicaleducation #orthoteaching