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Pediatric Nonscaphoid Carpal Fractures: Fracture Distribution and Operative Management in an Institutional Cohort and
Michael G Flood1, Samuel Rice, Aziz Khan
1Department of Orthopaedics and Physical Rehabilitation, University of Massachusetts Medical Center, Worcester, MA.
Pediatric nonscaphoid carpal fractures are rare, predominantly affecting adolescent males. Triquetrum fractures are most common, though hamate fractures are more frequently treated surgically.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Musculoskeletal Imaging
Background:
- Nonscaphoid carpal fractures in children are uncommon.
- Characterizing these injuries aids in understanding treatment patterns.
- Leveraging large electronic health record (EHR) databases offers insights into rare conditions.
Purpose of the Study:
- To define the epidemiology of pediatric nonscaphoid carpal fractures.
- To analyze demographic trends and injury mechanisms.
- To evaluate the operative management strategies for these fractures.
Main Methods:
- Retrospective review of a single institution's data (2017-2025).
- Analysis of two large deidentified EHR databases (TriNetX, Epic Cosmos) from 2015-2025.
- Fracture incidence, distribution, and surgical intervention rates (CPT codes) were calculated.
Main Results:
- Institutional cohort: 48 fractures, 72.9% male; triquetrum most common. Operative intervention in 4 patients (5 fractures).
- TriNetX: 4464 fractures; hamate (33.3%) most common, followed by triquetrum (28.5%).
- Epic Cosmos: 2126 fractures; triquetrum (36.3%) most common, followed by hamate (33.9%). Hamate fractures had the highest surgical intervention rate.
Conclusions:
- Pediatric nonscaphoid carpal fractures are rare, primarily seen in adolescent males.
- Triquetrum fractures are the most prevalent type.
- Hamate fractures exhibit the highest likelihood of surgical treatment among pediatric nonscaphoid carpal fractures.
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