Which part of the scaphoid is most at risk for avascular necrosis after fracture?

Which part of the scaphoid is most at risk for avascular necrosis after fracture?

• A. Distal pole
• B. Waist
• C. Proximal Pole
• D. Middle

Answer: (C)

Understanding scaphoid blood flow explains why the proximal pole is most at risk after a fracture. The scaphoid’s main blood supply comes from vessels that enter at the distal aspect and travel in a retrograde path toward the proximal pole. If a fracture disrupts these vessels, the proximal portion loses its blood supply first because it lies furthest along the retrograde route. That makes avascular necrosis most likely in the proximal pole. The distal pole has its own blood inflow and tends to be better perfused, while the waist fracture often jeopardizes the supplying vessels to the proximal region, underscoring why the proximal pole is the segment most vulnerable.

Understanding scaphoid blood flow explains why the proximal pole is most at risk after a fracture. The scaphoid’s main blood supply comes from vessels that enter at the distal aspect and travel in a retrograde path toward the proximal pole. If a fracture disrupts these vessels, the proximal portion loses its blood supply first because it lies furthest along the retrograde route. That makes avascular necrosis most likely in the proximal pole. The distal pole has its own blood inflow and tends to be better perfused, while the waist fracture often jeopardizes the supplying vessels to the proximal region, underscoring why the proximal pole is the segment most vulnerable.