Presentation
Chronic wrist pain post injury 6 months prior.
Patient Data
Non-united scaphoid waist fracture. Within the proximal fracture fragment adjacent to the fracture line is a T1 hypointense, T2 hyperintense region bordered by a low T2 rim that does not enhance. The remainder of the proximal fracture fragment shows a similar enhancement to the distal fracture fragment.
Comment: Approximately 25% avascular necrosis of the scaphoid proximal fracture fragment.
Case Discussion
Contrast-enhanced MRI has been shown to correlate well with intra-operative vascularity of the scaphoid, however, this appears independent from the success of scaphoid non-union surgery.