Scaphoid fracture epidemiology

Abstract

BACKGROUND:The current available literature related to scaphoid fracture epidemiology is inconsistent. The aim of this study was to describe the epidemiology of true scaphoid fractures in a defined adult population. METHODS:Using a prospective database, we identified all patients who sustained a radiographically confirmed acute fracture of the scaphoid over a 1-year period. Age, gender, mechanism of injury, the Herbert fracture classification, and associated injuries were recorded and analyzed. RESULTS:There were 151 scaphoid fractures diagnosed giving an annual incidence of 29 per 100,000 (95% confidence interval, 25-34). The median age of males was significantly younger when compared with females (p ϭ 0.002), with a male (n ϭ 105) predominance seen (p Ͻ 0.001). Low-energy falls from a standing height were most common (40.4%), but with males being significantly more likely to sustain their fracture after a high-energy injury (p Ͻ 0.001). The most common fracture was Herbert classification B2 (n ϭ 55, 36.4%), with unstable fractures more common in younger patients (p ϭ 0.025) following a high-energy injury (p ϭ 0.042). CONCLUSIONS: We have reported the epidemiology of true scaphoid fractures, with young males at risk of sustaining a fracture. Knowledge of the true incidence of scaphoid fractures and an understanding of the demographic risk factors are essential when assessing the suspected scaphoid fracture, particularly when considering further imaging modalities. (J Trauma. 2012;72: E41-E45. CopyrightA cute scaphoid fractures account for only 2% to 3% of all fractures and ϳ10% of all hand fractures. 1-3 The literature related to the epidemiology of scaphoid fractures is inconsistent with a hundred-fold difference quoted with regards the incidence. 2-8 This is potentially due to the retrospective nature of most analyses, the difficulty associated with defining the population assessed, and the limitation of many databases in distinguishing between suspected and confirmed fractures. 2-8 A clear understanding of the incidence, and the demographic risk factors, associated with a true scaphoid fracture is essential when considering the assessment of the suspected fracture.The aim of this study was to report the epidemiology and demographic risk factors associated with a true acute scaphoid fracture in a large defined population. PATIENTS AND METHODSOur trauma unit serves a captive adult (Ն13 years of age) population of ϳ514,479, with 244,112 males (47.4%) and 270,367 females (52.6%). All inpatient and outpatient fractures that presented acutely to our unit over a 1-year period from July 2007 to June 2008 were recorded prospectively. Patients who presented to our unit but who lived out with our local catchment area were excluded. The regional pediatric hospital manages patients aged less than 13 years and therefore these fractures were not included.A search of our prospective trauma database identified a subgroup of patients who had suffered an acute fracture of the scaphoid. Demographic data were collected for each p...

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

“…Another study in the UK included males and females of all ages who had sustained a scaphoid fracture over a 1-year time period [13]. Males with scaphoid fractures were younger than females, with a median age of 25 years compared to 40 years, similar to our result.…”

“…Unfortunately, we were unable to determine if these fractures were from standing height or higher in this study. The bimodal pattern in women could be a result of sports or risky activities in younger ages and agerelated problems (such as falls) post-menopause [13]. Additionally, we also observed an uneven side distribution for both sexes in our study, which may be the result of differing causes and trauma leading to the fracture, but we were unable to specifically determine the reason for this.…”

“…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. There are also very few studies of non-scaphoid carpal fractures [6].…”

The Scaphoid Safe Zone: A Radiographic Simulation Study to Prevent Cortical Perforation Arising from Different Views

“…Scaphoid fractures account for 10% of all hand fractures[1] and almost 60% of all carpal fractures[2]. The typical mechanism of injury is a fall onto a hyperextended and radially deviated wrist.…”

Scaphoid Fracture - Overview and Conservative Treatment

“…1-4) The mechanism of injury usually involves a fall on an outstretched hand, with the injury occurring during sporting activities such as football and basketball. [1][2][3] The most popular classification system for scaphoid fractures is Filan and Herbert's classification 5) which modified the Herbert classification (Fig. 1).…”