[Isolated fractures of the scaphoid: classification, treatment and outcome]

Scaphoid fracture is the most common fracture in carpal bone of the wrist and represents 11% of all upper extremity fractures. In most cases, the mechanism of injury is a fall with an outstretched hand. Scaphoid fracture detection can be made by clinical examination and standard radiography. Computed tomography (CT), bone scan and MRI improve the sensitivity of the diagnosis. Non-displaced fractures of the scaphoid are treated with cast immobilization in most cases. Operative treatment should be considered in displaced fractures or non-displaced fractures in young active patients by using internal fixation with cannulated screw for definitive anatomic and stable fixation. The main goals of operative treatment are attempts to reduce immobilization time and enable earlier return to work and activity. Displaced fractures of scaphoid, should be treated operatively, as they carry a greater risk for nonunion and malunion, which are associated with the development of radiocarpal arthritis, stiffness and wrist instability. Computed tomography is more useful as an assessment tool in pre-operative planning to determine the fracture location and fragment displacement. Early detection and appropriate treatment of scaphoid fractures is the key to favorable outcome in the treatment of scaphoid fractures.