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  schaphoid fracture   definition most of the time, a broken bone is obvious. The area around the break may be painful, swollen or deformed. But sometimes a bone can break without your realizing it. That’s usually what happens to the scaphoid (skaf'-oyd) bone in your wrist. Many people with a fractured scaphoid think they have a sprained wrist instead of a broken bone because there is no obvious deformity and very little swelling. The scaphoid bone is located on the thumb side of your wrist, close to the lower arm bones. buy cheap generic viagra canada It is shaped like a cashew nut. The blood supply to the bone enters from the top, but most fractures occur in the middle or lower portion of the bone. This presents a problem because the blood supply cannot reach the injury to encourage rapid, adequate healing. Who’s at risk? buy cheap generic viagra canada Scaphoid fractures account for about 60 percent of all wrist (carpal) fractures. They usually occur in men between ages 20 and 40 years, and are less common in children or in older adults. The break usually occurs during a fall on the outstretched wrist. It’s a common injury in sports and motor vehicle accidents. The angle at which the wrist hits the ground determines the injury. If the wrist is bent at a 90-degree angle or greater, the scaphoid bone will break; if the angle is less than 90 degrees, the lower arm bone (radius) will break. Signs and symptoms pain and tenderness on the thumb side of the wrist. Motion (gripping) may be painful. lowest price on viagra May be some swelling on back and thumb side of wrist. buy viagra overnight delivery Pain may subside, then return as a deep, dull aching. Marked tenderness to pressure on the "anatomical snuffbox," a triangular-shaped area on the side of the hand between two tendons that lead to the thumb. Diagnosis if you’ve fallen and think you’ve sprained your wrist, see your doctor as soon as possible. Your physician will ask you to describe what happened, examine your hand and wrist, and order x-rays of the area. Unless the fracture is displaced (the bone ends no longer touch each other), it may be difficult to see a scaphoid fracture on the first set of x-rays. Even if the initial x-rays do not show a scaphoid fracture, your physician may immobilize your wrist in a cast or splint for a week or so. Radiographs. Routine radiographs of the scaphoid include anteroposterior (ap), lateral, and oblique (45° from horizontal) views. The ap view is done with the fist mildly clenched and the wrist in ulnar deviation. (an ap view with a tightly clenched fist and ulnar deviation can be ordered to screen for ligament injury. ) the lateral view is done with the wrist in neutral position. get generic viagra online When the scaphoid is injured in the normal wrist, the lateral view shows a line of concentric arcs formed by the distal radius, lunate, and capitate. The longitudinal axis of these bones should be collinear. Disruption of this alignment suggests a ligament injury or dislocation, displacement, or angulation of a fracture. buy cheap generic viagra canada If radiographs are negative despite clinical suspicion of a scaphoid fracture, the patient's wrist is immobilized and radiographs are repeated in 2 weeks. If plain films continue to be negative but clinical suspicion remains, further imaging should be pursued. Bone scan and computed tomography have been used with about equal accuracy to detect occult fractures. Polytomography and magnetic resonance imaging (mri) can also be used though they are more expensive. generic viagra no prescription Mri can demonstrate much more anatomy and, because of increasing affordability, may soon become the standard for visualizing occult fractures and ligament disruptions. A bone scan taken two or three days after the injury can confirm the diagnosis. Or your physician may request a second set of x-rays after a week to ten days. Other diagnostic imaging tests that may be used include magnetic resonance imaging (mri) and computed tomography (ct) scan. Radiograph of fractured scaphoid mri of fractured schaphoid classification. Treatment decisions and outcome predictions are based on the location and stability of the scaphoid fracture. Acute, nondisplaced fractures are generally seen as a single lucent line through the scaphoid. lowest price viagra A fracture is considered unstable if more than 1 mm of displacement is seen between fragments or if the fragments are angled. In addition, the fracture is considered unstable if the lateral radiographic view shows malalignment of the carpal bones suggestive of fracture dislocation, or if the anteroposterior view shows carpal widening suggestive of ligament disruption. Fractures are localized within the proximal, middle (waist), or distal third of the bone. The incidence of avascular necrosis increases as fractures are located more proximally in poorly vascularized areas. Most scaphoid fractures occur at the waist, followed by the proximal pole and then the distal pole (1). Orientation of the fracture is a clue to its stability (figure 3). The most stable fracture orientation is the horizontal oblique, wherein the axis of the load is perpendicular to the fracture line. Transverse fractures may be unstable. The most unstable fracture has a vertical oblique orientation; fragments are vulnerable to longitudinal shearing forces from the radius. Treatment treatment is determined by the fracture site, the degree of displacement, and any associated injuries. Most scaphoid fractures are treated with immobilization in either a cast that covers the lower arm, the wrist and the thumb or one that covers the full arm, wrist and thumb. Healing time can range from six weeks for fractures in th. online ordering viagra

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Henry Duelberg' Salvia - Low maintenance, heat tolerant, native perennial with masses of showy blue flowers.

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Cape Plumbago - Tender perennial with profuse blue flowers which thrives in the hot Texas summer. Disease-, pest- and deer-resistant.

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'Tidal Wave Cherry' Petunia - Bright cherry red flowers that can be seen from a quarter mile away at 70 miles per hour.

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Variegated Tapioca - Tropical foliage plant grown as an annual in all but southern-most Texas. The variegated form is prized for its vivid chartreuse/yellow patterned leaves.

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'Texas Dawn' Water lily - Rich yellow flowers with a lemony fragrance. Green top leaves speckled purple with purple undersides.

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Deciduous Holly - Truly outstanding small native tree, very low maintenance, showy red or orange berries (on female plants). Attracts songbirds. Heat and drought tolerant.

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Dwarf Mexican Petunia - Spectacular, low-growing, heat-tolerant perennial with profusions of violet, light pink or white flowers. Highly pest resistant.

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Duranta, Brazilian Sky Flower - Rapid growing, dense shrub with small glossy leaves and a profusion of pendulous racemes of small flowers with colors varying from light blue to purple.

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Angelonia, Summer Snapdragon - Spreading annual with upright flower spikes that resemble minature snapdragons. Flower colors available include white, pink, purple, lavender, and lavender pink.

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Malvaviscus arboreus var. Drummondii, Turk's Cap - A rapidly growing, coarse textured plant that produces a profusion of "turban-like" flowers in various colors ranging from bright red to pink to white. Flowers attract hummingbirds and butterflies.

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