Scaphoid fractures in children –our experience

Gajdobranski Đ, Živanović D, Mikov A, Slavković A, Marić D, Marjanović Z, Milankov V

Anatomy

Carpal bones

„Scaphos“ = boat

Wrist joint

Parts

Vascularization

Površna grana radijalne arterije

Radijalnaarterija

Dorzalnaskafoidna grana

Volarnaskafoidna grana

Fracture characteristics

0,4%2,9% Younger Teenagers

Low intensity trauma

Distal part

Unicortical

Without dislocation

Diagnostic procedure

Clinical examination

Edema and hematoma

Pain

Grip strength

Stress tests

Radiological analysis

Radiography

MRI

CT

Bone scan

Scaphoid series

PA with ulnar deviation

Profile

Oblique

Scaphoid projection

Radiological analysis

Radiography

MRI

CT

Bone scan

Treatment

Conservative

Operative

Materials and methods

Retrospective study (2002 - 2010)

34 patients

Closed fractures, open physial plates

History, Clinical examination, Radiological analysis

Mayo Wrist Score

Results

Age

13,2 years

(9-15 years)N=34

M Ž

Sex distribution

79%

21%

M

F

Affected side

L

R

74%

26%82% Dominant hand

Mechanism of injury

Fall76%

Direct blow18%

Traffic accident3%

Unknown3%

Initial radiological finding

27

4

4

0

1

0 5 10 15 20 25 30

Positive

Suspected

Confirmed

Negative

Missed

Fracture location

65% - 22 patients

35% - 12 patients

0%

3 chronic fractures

Acute fracture treatment

90% 10%

4 - 8 weeks

+ 6 - 8 weeks+ magnetotherapy

7 weeks average

Outcome of treatment

6 lost to follow-up

Average follow-up period 3,5 months

Mayo Wrist Score – all patients – excellent (90 -100)

No Refractures or Avascular Necrosis

Conclusions

Conservative treatment of scaphoid fractures in children yields excellent results and is optimal treatment for this age group.

Patients with delayed fracture union, treated with prolonged immobilization and magnetotherapy leads to complete healing.

Thank You