Introduction A condition caused by AVN of scaphoid Epidemiology rare condition average age of onset is 45 years Presentation Symptoms dorsoradial wrist pain Imaging Radiographs show sclerosis and fragmentation of proximal pole without evidence of fracture MRI can further allow classification into complete vs partial involvement Treatment Nonoperative immobilization is effective in 20% of cases Operative microfracture drilling, revascularization procedure, or allograft replacement indications when nonoperative management fails techniques include drilling revascularization allograft replacements proximal row carpectomy or scaphoid excision with four corner fusion indications considered salvage procedures