الفهرس 
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Abstract
Scaphoid fractures are common but present unique challenges because of the particular geometry of the fractures and the tenuous vascular pattern of the scaphoid. Scaphoid fractures tend to occur in young adult men between the ages of 15 to 40 years and are rare in those under 10 years of age. The typical mechanism of injury is a fall onto a hyperextended and radially deviated wrist.
Diagnosing fractures of the scaphoid or injuries to the ligaments around the scaphoid poses a real challenge to the treating doctor. scaphoid fracture ultimately confirmed with repeat radiographs, clinical examinations, and, if necessary, CT or MRI Delays in diagnosis and inadequate treatment for acute scaphoid fractures can lead to nonunions and subsequent degenerative wrist arthritis. Improvements in diagnosis, surgical treatment, and implant materials have encouraged a trend toward early internal fixation, even for nondisplaced scaphoid fractures that could potentially be treated nonoperatively. Despite the advent of newly developed fixation techniques, including open and percutaneous fixation, the nonunion rate for scaphoid fractures remains as high as 10% after surgical treatment. Scaphoid nonunions can present with or without avascular necrosis of the proximal pole and may show a humpback deformity on the radiograph. If left untreated, scaphoid nonunions can progress to carpal collapse and degenerative arthritis. Surgical treatment is directed at correcting the deformity with open reduction and internal fixation with bone grafting For scaphoid fracture healing disturbances management , The goals of treatment for scaphoid nonunions and malunions are to achieve healing and to correct of any carpal deformities to prevent arthritis of the wrist. Nonoperative treatments of scaphoid nonunions include electrical or ultrasound bone stimulation combined with cast immobilization. Nonunion by conventional terms is a nonhealed scaphoid 6 months after injury, whereas a delayed union is a time frame that is less than 6 months. Although a nondisplaced scaphoid nonunion may be treated nonoperatively, a very long period of cast immobilization (4 to 6 months) is required. Because surgical treatments are more effective than bone stimulation for treatment of scaphoid nonunions, the indication for nonoperative treatment is restricted to patients who cannot have surgery for any reason. Currently available surgical techniques for the treatment of scaphoid nonunions include nonvascularized or vascularized bone grafting, with or without supplementary internal fixation. Unfortunately, salvage procedures may be necessary for scaphoid nonunions when advanced degenerative arthritis is present throughout the wrist. Salvage procedures include limited intercarpal fusion, proximal row carpectomy, scaphoid excision and four-corner fusion, total wrist arthroplasty, and total wrist fusion.