Scaphoid Fractures

1. Classification by Fracture Location
① Fracture of the scaphoid tubercle: This is where the joint capsule and ligaments attach; it is mostly an avulsion fracture. This area has a rich blood supply and tends to heal easily.
② Distal 1/3 fracture: The blood circulation at the distal end of the scaphoid is generally good, so healing is usually not an issue, though it may take some time.
③ Waist fracture: This is the most common type. Due to variations in the blood vessels entering the scaphoid, some scaphoids may have poor blood circulation at the waist, leading to longer healing times, with about 30% of fractures not healing.
④ Proximal 1/3 fracture: There are almost no blood vessels entering the proximal part of the scaphoid. After a proximal fracture, the blood supply from the scaphoid waist is interrupted, making healing extremely difficult, or leading to necrosis.
2. Classification by Fracture Stability
① Stable fracture: A fracture with no displacement or lateral displacement of less than 1mm.
② Unstable fracture: A fracture with lateral displacement greater than 1mm, backward displacement, or radial angulation, along with wrist extension instability or carpal dislocation. This type often requires surgical treatment.