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Current methods of diagnosis and treatment of scaphoid fractures
Authors:Steven J Rhemrev  Daan Ootes  Frank JP Beeres  Sven AG Meylaerts  Inger B Schipper
Affiliation:1.Department of Trauma Surgery,Medical Centre Haaglanden,The Hague,The Netherlands;2.Department of Trauma Surgery,Leids University Medical Centre,Leiden,The Netherlands
Abstract:Fractures of the scaphoid bone mainly occur in young adults and constitute 2-7% of all fractures. The specific blood supply in combination with the demanding functional requirements can easily lead to disturbed fracture healing. Displaced scaphoid fractures are seen on radiographs. The diagnostic strategy of suspected scaphoid fractures, however, is surrounded by controversy. Bone scintigraphy, magnetic resonance imaging and computed tomography have their shortcomings. Early treatment leads to a better outcome. Scaphoid fractures can be treated conservatively and operatively. Proximal scaphoid fractures and displaced scaphoid fractures have a worse outcome and might be better off with an open or closed reduction and internal fixation. The incidence of scaphoid non-unions has been reported to be between 5 and 15%. Non-unions are mostly treated operatively by restoring the anatomy to avoid degenerative wrist arthritis.
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