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Non-FOOSH Scaphoid Fractures in Young Athletes: A Case Series and Short Clinical Review
Michael R Johnson1, Brian T Fogarty2, Curt Alitz3
1US Army-Baylor University Postprofessional Sports Medicine, Physical Therapy Doctoral Residency, West Point, New York.
Context:
The scaphoid is the most commonly fractured bone in the wrist and can often be difficult to treat and manage, making healing of this fracture problematic.
Evidence Acquisition:
A search of the entire PubMed (MEDLINE) database using the terms scaphoid fracture management and scaphoid fracture evaluation returned several relevant anatomic and imaging references.
Results:
Wrist fractures most commonly occur in the scaphoid, which is implicated approximately 60% of the time. The most common mechanism of injury leading to a scaphoid fracture is a fall on an outstretched hand (FOOSH), causing a hyperextension force on the wrist. The following 2 cases, which occurred within 3 months of each other, highlight the difficulty of managing patients with possible scaphoid fractures. Neither patient had a typical FOOSH-related mechanism of injury, and neither was initially tender over the scaphoid.
Conclusion:
Differential diagnoses should include a scaphoid fracture with any hyperextension traumatic injury (FOOSH or non-FOOSH), even in the absence of scaphoid tenderness and when initial radiographic findings are normal.
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