Pediatric Nonscaphoid Carpal Fractures: Fracture Distribution and Operative Management in an Institutional Cohort and...

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.