Simultaneous fractures of the distal radius and scaphoid

Simultaneous fractures of the distal radius and the scaphoid are uncommon. A study of seven male patients who had sustained this fracture combination revealed the most frequent cause of the injury was a fall from a height. The distal radial fracture, usually unstable and intra-articular, was the principle fracture in this complex injury. In contrast, most of the scaphoid fractures were stable. Four of the radial fractures were treated by closed reduction and cast immobilization. In the remaining three, an external fixator was used to maintain the reduction. Four scaphoid fractures were immobilized in a cast, two were internally fixed, and one was left untreated. At an average follow-up period of 20 months (range from 12 to 52 months), all seven patients had regained satisfactory use of their hands. (Three results were classified as excellent and four good.) All scaphoid fractures healed. Transient avascular necrosis was noted in one scaphoid, but cleared within 5 months. Advanced radiocarpal arthritis developed in one wrist, but its presence did not adversely affect the late functional result.