Scaphoid nonunions in skeletally immature adolescents

Abstract

Scaphoid nonunions in children requiring operative treatment are rare. The aim of this study was to analyze our own patient population of the last 13 years to assess the postoperative outcome of these operations. Seven patients, under aged 14 years, were treated for scaphoid nonunions. Patients were clinically and radiologically examined and subjective outcomes were measured, such as the visual analogue pain scale (VAPS), Disability of the Arm, Shoulder and Hand (DASH) score, and Krimmer score. All patients showed an excellent outcome, as determined by the DASH score, Krimmer score, and VAPS. No differences between grip strength and range of motion between the operated and non-operated hand were observed. Therefore, we propose that scaphoid nonunions in skeletally immature adolescents can be treated satisfactorily with excision of the nonunion and bone grafting.

Evaluation of upper extremity function of displaced diaphyseal humeral fractures in children treated by elastic stable intramedullary nailing: preliminary results

“…First, although there is no set age limit, the Quick DASH questionnaire was developed for adults. However, 87.8% of our patients were older than 8 years of age and thus able to fully understand the questions and answer independently [18][19][20][21]. In addition, the DASH questionnaire has already been used to measure disability and symptom severity in a variety of arm disorders in children [14][15][16]20,21].…”

“…The Quick DASH questionnaire has the advantage of enabling a reproducible comparison of postsurgery functional outcome over time in patients with this type of fracture, including the capacity to detect and differentiate small and large changes in disability [18,19]. It has been shown that the Quick DASH questionnaire can be used to measure disability and symptom severity in a variety of arm disorders in children [14][15][16]20,21]. Canavese and colleagues used it to evaluate the functional outcome of proximal humerus fractures, Colovic and colleagues used it to assess elbow function after supracondylar fractures, Bae and colleagues used it in children with established malunion of the clavicle, and Behr and colleagues used it to evaluate scaphoid nonunion in skeletally immature adolescents [14][15][16]20,21].…”

Non-union of the great toe in a 4-year-old child

“…Fernandez et al 5 treated six cases of non-union of forearm shaft fractures in children after intramedullary nailing. Behr et al 6 reported seven cases of scaphoid, Cortes et al 7 treated one case of non-union following subtrochanteric femoral fracture in a child. Pourtaheri8 reported one case of clavicle non-union.…”

Vascularized thumb metacarpal periosteal pedicled flap for scaphoid nonunion: An anatomical study and pediatric case report

“…Though most pediatric scaphoid fractures have a good prognosis with conservative management (Weber, Fricker, & Ramseier, ), scaphoid nonunion has been reported (Ahmed, Ashton, Tay, & Porter, ; Behr et al, ; Elhassan & Shin, ; Reigstad, Thorkildsen, Grimsgaard, Reigstad, & Rokkum, ). Since this lesion is a rarity, however—with a nonunion rate of just 0.8% (Elhassan & Shin, )—management experience is limited and optimal treatment remains controversial (Elhassan & Shin, ).…”