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Patient-Related Factors Associated With Scaphoid Proximal Pole Avascular Necrosis Healing
Sophia Jacobi1, Emily Davidovic-Katz1, Michelle Richardson1
1NYU Langone Health, New York City, USA.
Hand (New York, N.Y.)
|January 26, 2026
Summary
Patient factors like hyperlipidemia, advanced age, and high BMI negatively impact avascular necrosis (AVN) healing after scaphoid fractures. Surgical graft choice did not significantly affect AVN healing outcomes.
Area of Science:
- Orthopedic surgery
- Bone healing research
- Complication analysis in fractures
Background:
- Avascular necrosis (AVN) of the proximal pole is a known complication of scaphoid fractures.
- Understanding the factors influencing AVN healing remains incomplete.
- This study investigates patient-specific factors affecting proximal pole AVN healing.
Purpose of the Study:
- To evaluate patient-related factors associated with healing outcomes in proximal pole AVN post-scaphoid fracture.
- To identify predictors of successful AVN resolution.
- To inform prognosis assessment for patients with scaphoid fractures.
Main Methods:
- Retrospective review of 62 patients diagnosed with scaphoid proximal pole AVN (2018-2024).
- Collected patient baseline characteristics, comorbidities, and surgical factors.
- Assessed primary outcome of AVN healing at 4-month follow-up.
Main Results:
- 48.4% of patients achieved AVN resolution.
- Hyperlipidemia, advanced age, and elevated BMI were significantly associated with lack of healing (P < .05).
- No significant difference in healing outcomes was observed between nonvascularized grafts, no graft, and vascularized bone flaps (P > .115).
Conclusions:
- Hyperlipidemia, elevated BMI, and advanced age are key patient factors negatively impacting scaphoid proximal pole AVN healing.
- These findings are crucial for accurate patient prognosis.
- Surgical approach (graft type) does not significantly influence AVN healing outcomes.
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