Which pattern of scaphoid fracture carries the HIGHEST risk of avascular necrosis of the proximal fragment?

• A Fracture of the distal tubercle
• B Fracture of the distal third
• C Fracture through the waist
• D Fracture of the proximal pole ✓

Explanation

The scaphoid is supplied retrogradely by branches of the radial artery entering its dorsal surface near the waist, so blood flows distal to proximal. A proximal pole fracture detaches the entire fragment from its arterial supply, giving the highest rate of nonunion and avascular necrosis. Waist fractures have intermediate risk, while tubercle and distal third fractures retain their blood supply and rarely become necrotic.

Reference: Apley's System of Orthopaedics and Fractures, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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