The epidemiology of scaphoid fractures in Sweden: a nationwide registry study

Abstract

The epidemiology of scaphoid fractures has been described in limited populations, and incidence reports have been inconsistent. We investigated the nationwide incidence of scaphoid fractures by evaluating data on 34,377 patients in the Swedish National Patient Register for the years 2006–2015 regarding diagnosis, age, sex and treatment. The data were validated in 300 random patients, and incidence rates were adjusted accordingly. Forty-one per cent of the initially diagnosed fractures were false positives. The adjusted true fracture incidence rate was 22 per 100,000 person-years. During the decade studied incidence rates decreased in younger men and increased in middle-aged women. The incidence of surgical treatment vs. non-operative treatment did not change over time. Men were treated surgically more often than women (6% vs. 3%) and had a greater risk for nonunion (3% vs. 1%).

Epidemiology of scaphoid fractures and non-unions: A systematic review

“…However, it has previously been reported that females have a young as well as old age peak incidence [19,27]. In a recent register study, the scaphoid fracture incidence was approximately 15/100 000 for people above 70 years of age [20].…”

“…At a national register encompassing 34,377 patients diagnosed as scaphoid fractures, the authors went through the medical charts and radiographic examinations of 300 randomly selected patients. They found that as many as 41 % of patients who initially were registered as having a scaphoid fracture in fact did not have a fracture [20].…”

“…Mean age at the diagnosis was 20.3 to 26.3 years of age. Compared to acute scaphoid fractures there seems to be an even stronger male predominance with a male to female ratio ranging from 2.6:1 to 18:1 [10,18,20,[38][39][40][41].…”

“…These studies included a total of 1603 acute scaphoid fractures. In addition, three register studies encompassed 35 493 scaphoid fractures [20,28,29]. In the majority of studies, the fracture diagnosis was based on conventional radiographs, while in two studies [21,22] it was based on CT and MRI combined, and one study [26], with focus on proximal pole fractures, CT was used for diagnosis.…”

“…In addition, two register studies were evaluated, one of which encompassed 7149 non-unions [40]. A register study [20] found that out of 10122 acute scaphoid fractures, 245 turned into a non-union. It corresponds to an estimated 2 % risk for non-union, within 5 to 9 years after a fracture.…”