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[Coronal fractures of scaphoid]
1Service de chirurgie orthopédique, hôpital Cochin, 27, rue du faubourg-Saint-Jacques, 75014 Paris, France. avidil@club-internet.fr
Chirurgie De La Main
|August 6, 2004
Summary
High-energy trauma can cause frontal fractures of the scaphoid proximal pole. Advanced imaging like CT scans is crucial for timely diagnosis and assessing associated injuries to ensure proper treatment and outcomes.
Area of Science:
- Orthopedic Surgery
- Radiology
- Trauma Care
Background:
- Frontal fractures of the scaphoid proximal pole are rare injuries.
- High-energy trauma is a common cause of these fractures.
- Delayed diagnosis can lead to complications such as malunion and persistent pain.
Observation:
- Two cases of frontal scaphoid fractures are presented, both initially diagnosed late.
- One patient with a minimally displaced fracture achieved excellent outcomes with conservative treatment.
- The second patient, experiencing persistent pain and malunion, required surgery, revealing the correct diagnosis intraoperatively.
Findings:
- Computed tomography (CT) scans were essential for diagnosing the fractures in both cases.
- X-rays postoperatively revealed a characteristic 'double contour' of the scaphoid proximal pole in both patients.
- Surgical intervention in the second case led to a proximal row carpectomy due to scaphoid malunion.
Implications:
- ArthroCT or MRI is recommended for precise assessment of fracture displacement and associated ligamentous injuries.
- Timely and accurate diagnosis is critical for optimal management of frontal scaphoid fractures.
- Advanced imaging may improve surgical planning and patient outcomes in complex wrist trauma.