الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The scaphoid is the most commom carpal bone to be fractured and it is notorious for trouble with healing. It seems that the majority of these are unstable and malaligned. Scaphoid nonunion and malunion has several risk factors like delayed diagnosis, inadequate immobilization, fracture pattern and displacement, poor surgical technique, proximal pole fractures and associated ligamentous injury.The most common clinical sign of a scaphoid nonunion or malunion is restricted wrist motion but other suggestive findings may be present.Typical radiographic signs of nonunion are widening of the fracture cleft, cyst formation and sclerosis of the fracture surfaces. CT is abetter diagnostic method especially for scaphoid malunion. MRI is often used to diagnose AVN, especially in the proximal pole. Bone scans are nonspecific, because scaphoid bone is very small. The two signs that significantly correlated with AVN were increased radiodensity of the proximal pole (often termed sclerosis) and the absence of converging trabeculae between the fragments.The goals of treatment for scaphoid nonunion include union, correction of deformity, relief of symptoms, and limitation of arthrosis. It can be divided into reconstructive and salvage procedures.Reconstructive procedures include internal fixation with Kirschner wires or compression headless screw with the option to be introduced minimally invasive or arthroscopiccally, volar buttress plate and external fixation by Ilizarov device. With or without bone Stimulation with electrical stimulant.