Scaphoid In Children Research Articles

The Role of Dynamic Contrast-Enhanced MRI in a Child with Sport-Induced Avascular Necrosis of the Scaphoid: A Case Report and Literature Review

Avascular necrosis (AVN) of the scaphoid in children is very rare and there is currently no consensus when conservative or operative treatment is indicated. A 10-year-old boy, practicing karate, presented with acute pain in his left wrist after falling on the outstretched hand. Imaging showed a scaphoid waist fracture with signs of an ongoing AVN. The diagnosis of AVN was confirmed with signal loss of the scaphoid on MRI T1. A dynamic contrast-enhanced MRI was performed for further assessment of the proximal pole vascularity and treatment planning. As dynamic contrast-enhanced MRI showed fair perfusion of the proximal pole, an adequate healing potential with conservative treatment was estimated. We achieved union and good function with cast immobilization for fourteen weeks. This case study showed dynamic contrast-enhanced MRI to be a valuable tool in assessing whether conservative or operative treatment is indicated to achieve union and good functional outcome.

Avascular necrosis of the scaphoid in children treated by splint immobilisation

Avascular necrosis of the scaphoid following a fracture in children is rare and there is no established treatment protocol in the literature. We present two boys with nonunion and avascular necrosis of the scaphoid treated by simple immobilisation. Both cases healed with painless wrists and full movements. Our cases confirm that an ununited scaphoid fracture in children may heal with conservative treatment, even when an MRI scan suggests avascular necrosis. Unlike in adults, operative treatment need only be considered in children when conservative treatment fails.

Fractures of the carpal scaphoid in children. A series of eight cases.

Journal Article Fractures of the carpal scaphoid in children: A series of eight cases Get access M Grundy M Grundy Department of Orthopaedic Surgery, Manchester University Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 56, Issue 7, July 1969, Pages 523–524, https://doi.org/10.1002/bjs.1800560713 Published: 07 December 2005

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.

Nonunion of the scaphoid in children treated by Herbert screw fixation and bone grafting. A report of five cases

In children, nonunion of fractures of the waist of the scaphoid is uncommon. Treatment has included bone grafting without internal fixation, bone grafting with Kirschner-wire fixation, and screw fixation without bone grafting. We report the successful use of Herbert screw fixation and iliac-crest bone grafting in five cases, all of which healed without further surgery. At an average follow-up of 3.3 years, the range of motion, grip strength, carpal stability, and radiological appearances were all excellent.

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

Two cases of non-union of fractures of the carpal scaphoid in children are described. They were successfully treated by screw fixation without bone grafting.

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.

Fractures of the scaphoid.

Fracture of the scaphoid is the most common injury of the carpus. Inadequate treatment frequently leads to non-union, which causes pain and serious disability. In the present study 134 scaphoid fractures treated during the period 1961-70 are reviewed. In fresh fractures less than 4 weeks old, bony union occurred in 95% with proper conservative treatment. The vexed question of whether a high or low circular cast should be used may not really be so important. In the present study, both methods of external splintage have given favourable results. It is indisputable, however, that other factors, such as the age of the fracture, its type and location are of great importance for the final result. It was also found that fracture dislocation greater than 1 mm regularly led to pseudarthrosis. Operative treatment is suggested in these cases, and the Matti-Russe technique has proved to be an excellent method for treatment of pseudarthrosis of the scaphoid. The study further confirmed that fractures of the scaphoid in children are more common than is usually supposed. They were all located in the distal two-thirds of the bone and it is suggested that this pattern of distribution is typical of childhood.

Fractures of the carpal scaphoid in children : M. Grundy. Brit. J. Surg. 56:523–524 (July) 1969

Fractures of the carpal scaphoid in children : M. Grundy. Brit. J. Surg. 56:523–524 (July) 1969

Injuries of the Carpal Scaphoid in Children

Injuries of the Carpal Scaphoid in Children

Injuries of the Carpal Scaphoid in Children

Injuries of the Carpal Scaphoid in Children

Köhler's Disease of the Tarsal Scaphoid in Children

Köhler's Disease of the Tarsal Scaphoid in Children