case_images: PMC6815601_01
case_images: AP and lateral radiographs from November 2016 (approximately 3 years and 1 month from the initial injury) demonstrating a nondisplaced scaphoid waist fracture and a subtle osteosclerotic appearance within the proximal pole. There is also a relative sclerotic appearance of the scaphoid relative to the other carpal bones:a constellation of findings concerning for osteonecrosis.
case_images: CRIOR2019-4701585.001.jpg
case_images: PMC6815601_01_CRIOR2019-4701585.001.jpg
case_images: fig1
case_images: Interval radiographs revealed a right-sided, displaced scaphoid waist fracture (Figure 1).
case_images: (a) Coronal T1-weighted magnetic resonance (MR) image of the right wrist showing diffuse loss of signal throughout the scaphoid bone that is concerning for osteonecrosis; (b) sagittal fat-suppressed PD-w MR image of the right wrist. The presence of a fracture line is indicative of nonunion.
case_images: CRIOR2019-4701585.002.jpg
case_images: PMC6815601_01_CRIOR2019-4701585.002.jpg
case_images: fig2
case_images: AVN (Figure 2). At this point, the patient and parents elected to undergo surgical fixation of his nonunion.
case_images: AP and lateral radiographs taken two weeks postsurgical fixation using two Arthrex micro screws.
case_images: CRIOR2019-4701585.003.jpg
case_images: PMC6815601_01_CRIOR2019-4701585.003.jpg
case_images: fig3
case_images: Two weeks later, he presented to clinic with resolution of pain and intact hardware on imaging (Figure 3).