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Carpal scaphoid fracture in the skeletally immature: a single centre one-year prospective study
1Keele University School of Medicine, Stoke on Trent, United Kingdom.
Insights
Scaphoid fractures are uncommon in children, with a low incidence observed in UK trauma centers. Most pediatric scaphoid fractures are undisplaced and have a good prognosis with appropriate management.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Radiology
Background:
- Scaphoid fractures are common in adults but their incidence in skeletally immature patients is less understood.
- Management and outcomes of pediatric scaphoid fractures require further investigation.
Purpose of the Study:
- To determine the incidence of scaphoid fractures in skeletally immature patients.
- To describe the characteristics and management of these injuries.
Main Methods:
- Prospective data collection over one year from a UK Level I Trauma Centre Fracture Clinic.
- Inclusion of 121 skeletally immature patients with suspected scaphoid fractures.
- Diagnosis and follow-up solely via plain radiography; immobilization until union.
Main Results:
- Fourteen patients (11.5%) were diagnosed with scaphoid fractures.
- Incidence rate of 15 per 100,000, representing 0.55% of all referred pediatric injuries.
- Mean delay to consultation was 2.6 days; mean follow-up was 52.3 days.
- Fractures were typically undisplaced, distal, and managed conservatively.
Conclusions:
- Scaphoid fractures in skeletally immature individuals are uncommon.
- These fractures usually present as undisplaced, distal injuries with a favorable prognosis.
- Plain radiography is sufficient for diagnosis and follow-up in this population.
Abstract:
We report up-to-date one-year prospective data on the incidence of scaphoid fracture in skeletally immature patients managed in a Fracture Clinic of a Level I Trauma Centre in a University Hospital in the UK. All scaphoid fractures were immobilised until union was achieved. One hundred twenty one skeletally immature patients were referred for a suspected fracture of the scaphoid. Fourteen patients (11.5%) did have a scaphoid fracture, an incidence of 15 per 100,000 (0.55% of all paediatric injuries referred). Mean delay in being seen was 2.6 days, and mean follow-up time was 52.3 days. Only plain radiography was used to diagnose and follow up scaphoid fractures. Fractures of the scaphoid in skeletally immature individuals are uncommon, are usually undisplaced, occur more commonly in the distal portion of the bone, and carry a good prognosis.
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