Question:
Which part of a scaphoid fracture is most susceptible to avascular necrosis?
Which part of a scaphoid fracture is most susceptible to avascular necrosis?
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Retrograde blood supply makes the proximal pole most prone to AVN.
Updated On: Jun 23, 2026
- Distal 1/3rd
- Middle 1/3rd
- Proximal 1/3rd
- Scaphoid tubercle
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The Correct Option is C
Solution and Explanation
Step 1: The scaphoid receives its blood supply mainly from branches of the radial artery that enter through the distal pole and run in a retrograde (distal-to-proximal) direction to supply the proximal pole.
Step 2: Because the proximal pole has no separate direct blood supply and depends on this retrograde flow, a fracture proximally cuts off the proximal fragment from its blood supply.
Step 3: Therefore proximal-pole (proximal third) fractures carry the highest risk of avascular necrosis and non-union. This makes option (c) correct.
Step 4: Although waist fractures are the most common (70-80 percent), they are not the most prone to AVN; the more proximal the fracture, the greater the risk to the proximal fragment's vascularity. Distal fractures and the tubercle have a good blood supply and rarely undergo AVN.
Step 2: Because the proximal pole has no separate direct blood supply and depends on this retrograde flow, a fracture proximally cuts off the proximal fragment from its blood supply.
Step 3: Therefore proximal-pole (proximal third) fractures carry the highest risk of avascular necrosis and non-union. This makes option (c) correct.
Step 4: Although waist fractures are the most common (70-80 percent), they are not the most prone to AVN; the more proximal the fracture, the greater the risk to the proximal fragment's vascularity. Distal fractures and the tubercle have a good blood supply and rarely undergo AVN.
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