Fracture of the Carpal Scaphoid in Children:<i>A Clinical and Roentgenological Study of 108 Cases</i>

Vahvanen, Veijo; M, Westerlund

doi:10.3109/17453678008990893

Cited by 108 publications

(49 citation statements)

References 8 publications

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“…19 For example, in the present series 3 patients were completely asymptomatic, and nonunion was discovered only when they were examined radiographically for another injury.…”

Section: Discussionmentioning

confidence: 90%

“…Most are undisplaced and can be managed successfully with immobilization. 1,5,11,19 As in adults, the scaphoid is the most commonly fractured carpal bone in children, 1,6,19 -22 with a peak incidence of about 15 years. 6,23 In the immature skeleton, most scaphoid fractures involve the distal third of the bone, and therefore nonunions are rare.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Scaphoid Nonunion

Chloros¹,

Themistocleous²,

Wiesler³

et al. 2007

The Journal of Hand Surgery

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“…19 For example, in the present series 3 patients were completely asymptomatic, and nonunion was discovered only when they were examined radiographically for another injury.…”

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Pediatric Scaphoid Nonunion

Chloros¹,

Themistocleous²,

Wiesler³

et al. 2007

The Journal of Hand Surgery

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“…1,4,9 Given the high potential for mismanagement it is of paramount importance that any child with a clinical suspicion of a scaphoid fracture even with negative radiographs must receive early orthopaedic input and management in a scaphoid type forearm-hand cast. 8 In one study there was a 1-2-week delay in diagnosis of scaphoid fractures in <12.5% of cases. 1 In our case, initial radiological evaluation involved plain AP and lateral wrist X-rays, which did not show any obvious fracture.…”

Section: Discussionmentioning

confidence: 96%

Established scaphoid nonunion progressing to spontaneous union in a child

2006

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Scaphoid fractures in children are uncommon and account for approximately 0.38% of paediatric fractures. Prompt and adequate immobilisation in a scaphoid cast is necessary for successful treatment. Virtually all scaphoid fractures in children will unite with such conservative measures. We report a case of an established scaphoid nonunion in an 11-year-old child, which spontaneously united 2 years after the initial injury. There appear to be no similar cases in the literature. There is one reported case in an adult, but this represents a separate patient group which behaves differently due to skeletal maturity. This case highlights the importance of appropriate orthopaedic follow-up and radiological examination in a child with a clinical suspicion of a scaphoid fracture, in order to prevent progressive arthritis and nonunions warranting surgical intervention

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“…[1][2][3][4][5][6][7][8] Single carpal bone fractures in children are uncommon. However multiple carpal fractures in this age group are very rare indeed.…”

Section: Discussionmentioning

confidence: 99%

Paediatric multiple carpal fractures: A case report

2008

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An 11-year-old boy presented after sustaining an injury to his dominant right wrist after a brick wall had collapsed onto it. Standard radiographs of the hand were obtained displaying multiple carpal bone fractures (Figs. 1 and 2). Computerised tomograms confirmed the presence of fractures involving the capitate, hamate, triquetrum and pisiform . He was managed conservatively in a below elbow cast for 5 weeks.At 2-month follow-up he was completely pain free and the right wrist was minimally more swollen then the left. The patient was able to palmar/dorsi-flex to 50% on the right in comparison to the left. However a full range of pronation/ supination was present. At this stage radiographs revealed the capitate and hamate had yet to unite.At 4-month follow-up he remained asymptomatic; he recovered his full range of movement. Radiographs showed a healing capitate fracture. At 6-month follow-up he had a fully functioning non-painful wrist and was discharged from clinic.The patient was recalled to clinic at 3 years. He was asymptomatic, using his wrist fully and was participating in all sports including goalkeeping in football. On examination the wrist was normal with no swelling and no deformity. There was no tenderness on palpation and no pain on stressing the wrist. Active range of motion was full and equal to the normal wrist. Radiographs revelaed that the capitate fracture had united but the hamate fracture remained ununited (Figs. 6-9). This was confirmed on CT scanning. DiscussionFractures and dislocations in the paediatric carpus are extremely rare. As an anatomical structure the immature carpus is a relatively cartilaginous and therefore fairly immune to injury.Carpal injuries are often a diagnostic and therapeutic conundrum. The combination of a difficult to examine patient and the limited ability of X-rays to detail the immature skeleton are all contributing factors. 2-7 Our patient was almost skeletally mature and the fractures were clearly evident on X-ray.The Scaphoid is the most frequently injured carpal bone in children, and in adults; one of the few similarities in skeletally mature and immature patients. 1-8 Single carpal bone fractures in children are uncommon. However multiple carpal fractures in this age group are very rare indeed. Goddard emphasises the importance of being aware of the possibility of combination injuries (particularly in association with distal radial fractures) and the value of MRI in excluding ligamentous damage. 2 Garcia-Elias et al. proposed that crush injuries of the adult carpus involved a disruption of the transverse carpal arch. There is involvement of the flexor retinaculum and the capito-hamate and piso-triquetral joints. It was postulated that these joints acted as a ''weak zone''. All described cases displayed medial dislocation of the ulnar structures as one unit, whilst the radial carpal bones Injury Extra (2008) 39, 247-249

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Fracture of the Carpal Scaphoid in Children:A Clinical and Roentgenological Study of 108 Cases

Cited by 108 publications

References 8 publications

Pediatric Scaphoid Nonunion

Pediatric Scaphoid Nonunion

Established scaphoid nonunion progressing to spontaneous union in a child

Paediatric multiple carpal fractures: A case report

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