What are common complications of scaphoid fracture?

• A. Osteoarthritis
• B. Nonunion or avascular necrosis
• C. Tendon rupture
• D. Carpal tunnel syndrome

Answer: (B)

Scarcity of blood supply to the scaphoid is the key issue. The scaphoid receives most of its blood flow retrogradely, entering distally and moving toward the proximal part. When a fracture occurs, especially through the waist or involving the proximal pole, this blood supply can be disrupted. The proximal fragment can thus become avascular, leading to avascular necrosis, and the already limited blood flow impairs healing, causing nonunion. These two problems—nonunion and avascular necrosis—are the most common and clinically important complications after a scaphoid fracture. Osteoarthritis can develop later if healing is poor or there’s malalignment, but it’s a downstream consequence rather than the immediate complication. Tendon rupture and carpal tunnel syndrome aren’t typical direct complications of this injury.