The Natural History of a Missed Scaphoid Fracture

Scaphoid fractures are known to be a difficult diagnosis since they can be accompanied by unspecific physical complaints. Furthermore, they are difficult to visualize on standard x-ray examinations. The purpose of this report is to stress the importance of adequate diagnosis and treatment of scaphoid fractures. We describe a 50-year old female, with progressive wrist pain after a skiing accident, who was diagnosed with an untreated scaphoid fracture. This scaphoid fracture had developed into a scaphoid non-union advanced collapse of the wrist. The scaphoid non-union advanced collapse was treated with a four-corner arthrodesis and a Wafer procedure, which ultimately led to an acceptable situation. This report presents a rare complication of a missed scaphoid frac ture. X-rays of the wrist commonly fail to demonstrate fractures of the scaphoid bone. There fore more invasive imaging techniques must be used to diagnose a scaphoid fracture. doi:10.4021/jmc287w