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I am grateful to have a wonderful support structure of family and friends and I love all of you. All updates will be located in the My Journal section of the site that also posts to Facebook. My lifelong Goal, isunderstanding the way the body works,how it fails and how it heals.My Passion, is findingsolutions for hand, wrist and elbow problems. An MRI may be useful in evaluating the blood supply of the scaphoid for avascular necrosis (Figure 4). In cases without significant arthritis, the goal is to restore scaphoid alignment and to achieve bone healing.


For those fractures associated with advanced arthritis or for persistent non-unions despite reconstructive efforts, further surgery to heal the scaphoid may no longer be indicated. Thank you for the encouraging emails, stopping to talk with me at work, sending text messages, sending Facebook messages, sending snail mail letters and cards,…. Some patients present with a fracture that was never recognised, maybe recalling a bad “sprain” at some time in the past but then later developing more problems with their wrist.
This information is useful for determining the prognosis for recovery and for pre-operative decision making. There may be loss of motion, particularly of wrist extension, making it hard to do things like push-ups, and there is often decreased strength.


Diagnosis is confirmed most commonly with X-rays (Figure 2), although additional studies may be obtained, such as a CT scan or MRI, to assist with the diagnosis and for pre-operative planning. Fractures of the portion of the scaphoid closest to the forearm, the proximal part, are especially vulnerable to loss of the blood supply to that part of the bone, which may die as a result, a condition called “avascular necrosis.”??A “non-union” refers to a fracture which has not demonstrated signs of healing despite adequate time to do so, usually a few months. With a non-union, the fracture edges may erode somewhat and the scaphoid may bend on itself through the fracture site, resulting in a so-called “humpback” deformity (Figure 3).



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