Scaphoid Fractures In Children Research Articles

Diagnostic Approach for Suspected Scaphoid Fractures in Children.

Scaphoid fractures in children are rare injuries. A complete scaphoid waist fracture in a 13-year-old boy after fall on the extended wrist is reported. Following early diagnosis by MRI, the fracture healed uneventful with conservative treatment. The appropriate diagnostic approach and the advantages of MRI for suspected scaphoid fractures in children are discussed.

Established scaphoid nonunion progressing to spontaneous union in a child

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.

Scaphoid Fractures in Children: Problems and Treatment

From 1984 to 1999, the authors treated 64 cases of fracture of the scaphoid in children. Causes of injury were sports (n = 27), punching game machines or fighting (n = 22), and traffic accident or other trauma (n = 15). Most (46 cases) were nonunion cases. Eighteen cases were acute. Cast immobilization was performed in 10 acute cases and two nonunion cases. Screw fixation was performed in 52 cases, including 35 cases of bone graft. In 10 of these operated cases, freehand screw insertion was used. Ultimately, good bony fusion was achieved in all cases, but in two nonunion cases a secondary bone graft was necessary. Functional results in all cases were acceptable. A major problem is that children are not brought to clinics immediately after injury, so the percentage of nonunion is high.

Scaphoid fractures in children

A fracture of the scaphoid in the wrist of a 6-year-old girl and eight new cases of scaphoid fractures in children are reported.

Two cases of non-union of carpal scaphoid fractures in children

Two cases of non-union of fractures of the carpal scaphoid in children are described, which were successfully treated by cancellous bone grafting with Kirschner wire fixation.

FRACTURE OF THE CARPAL SCAPHOID IN CHILDREN

A series of 108 carpal scaphoid fractures in children was analysed with respect to the site, type and treatment of the fracture. The patients were followed until radiological fusion occurred. All fractures united and healed completely with conservative treatment. Ninety-four fractures, 41 of which were avulsions, were located in the distal third of the scaphoid. There were 13 waist fractures, and one avulsion fracture was located in the proximal pole of the scaphoid. The great number of avulsion fractures and the location of the fractures in the distal third of the scaphoid is very typical in children. In three neglected cases marked bone resorption was seen on the fracture surface 3 weeks after the injury. Because non-union is possible especially in neglected cases of waist fractures, control radiographs should be taken 1 or 2 weeks after the injury if the fracture is not visible on the primary radiographs but is suspected clinically. Immobilization with an adequate plaster cast is mandatory in all transverse fractures of the carpal scaphoid in children.

Fracture of the carpal scaphoid in children. A clinical and roentgenological study of 108 cases.

A series of 108 carpal scaphoid fractures in children was analysed with respect to the site, type and treatment of the fracture. The patients were followed until radiological fusion occurred. All fractures united and healed completely with conservative treatment. Ninety-four fractures, 41 of which were avulsions, were located in the distal third of the scaphoid. There were 13 waist fractures, and one avulsion fracture was located in the proximal pole of the scaphoid. The great number of avulsion fractures and the location of the fractures in the distal third of the scaphoid is very typical in children. In three neglected cases marked bone resorption was seen on the fracture surface 3 weeks after the injury. Because non-union is possible especially in neglected cases of waist fractures, control radiographs should be taken 1 or 2 weeks after the injury if the fracture is not visible on the primary radiographs but is suspected clinically. Immobilization with an adequate plaster cast is mandatory in all transverse fractures of the carpal scaphoid in children.

Nonunion of carpal scaphoid fractures in children : R. Southcott and M. A. Rosman. J. Bone Joint Surg. 59B:20–23 (February), 1977

Nonunion of carpal scaphoid fractures in children : R. Southcott and M. A. Rosman. J. Bone Joint Surg. 59B:20–23 (February), 1977

Non-union of carpal scaphoid fractures in children

Fracture of the carpal scaphoid is uncommon in children, but does occur and may fail to unite. Eight patients with established non-union have been reiewed, with an average follow-up of almost four years. All non-unions were grafted with autogenous bone. Excellent clinical and radiological results have been obtained. It is concluded that non-union in children is best managed by bone grafting through the anterior approach. Possible aetiological factors concerned in non-union of scaphoid fractures in this age group are discussed.