Acute scaphoid fracture: a review

Abstract

The scaphoid is by far the most commonly fractured carpal bone. Occult fractures, imperceptible on initial radiographs and a reputation for non-union make diagnosis and management challenging. The past few years have seen significant advances in the assessment and surgical treatment of scaphoid fractures. This article reviews the published literature relating to acute scaphoid fractures and examines the advances that have been made in management.

Carpal and scaphoid fracture incidence in south-eastern Australia: an epidemiologic study

“…According to published literature, most scaphoid fractures occur in young adult men, between 20 to 30 years of age and in women, between the ages of 40-50 years [9]. We observed similar patterns in our study.…”

“…The proportions of fractures occurring on the left and right sides were also determined to investigate whether there was a difference between males and females. It has been reported that scaphoid fractures occur more frequently in younger men, who may fracture more commonly on the right side from manual labour activities [9]. Females may be expected to fracture more evenly on both sides, as they have been reported to sustain scaphoid fractures at an older age, mainly as a result on falling onto an outstretched hand.…”

“…Scaphoid fractures are also problematic because diagnosis and treatment are difficult [8,9]. Scaphoid fractures are often complicated by non-union, osteonecrosis, tendon injuries and/or carpal tunnel syndrome, resulting in functional morbidity and eventual arthritic degeneration [7][8][9]. Additionally, presentation may be delayed when the injury is attributed to a wrist sprain instead of a more serious fracture event [10], resulting in higher levels of complications when treatment is commenced.…”

“…Additionally, presentation may be delayed when the injury is attributed to a wrist sprain instead of a more serious fracture event [10], resulting in higher levels of complications when treatment is commenced. Conversely, difficulties in diagnosis may lead to treatment for a scaphoid fracture, when the actual injury is a wrist sprain [9,11]. There are several studies that describe the epidemiology of scaphoid fractures [6,[10][11][12][13], but data are lacking for Australia.…”

“…Annual incidence rates for all ages of 23-43 per 100,000 persons per year have been reported [7]. Scaphoid fractures are also problematic because diagnosis and treatment are difficult [8,9]. Scaphoid fractures are often complicated by non-union, osteonecrosis, tendon injuries and/or carpal tunnel syndrome, resulting in functional morbidity and eventual arthritic degeneration [7][8][9].…”