Wells Matthew E, Nicholson Tyler C, Macias Reuben A, Nesti Leon J, Dunn John C
Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, Texas.
Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center El Paso, El Paso, Texas.
J Wrist Surg. 2021 Apr;10(2):123-128. doi: 10.1055/s-0040-1720963. Epub 2020 Nov 11.
The scaphoid is the most commonly fractured carpal bone and often presents as a diagnostic challenge. Fractures can often go unnoticed on initial radiographic evaluation and clinical presentation can vary significantly among patients. Awareness of high-risk cohorts assists practitioners in making the appropriate clinical diagnosis of acute scaphoid fracture. The National Trauma Data Bank is the world's largest trauma data repository. Utilizing the 2016 public use file, we isolated scaphoid fractures by anatomic fracture location by utilizing International Classification of Diseases, 10th revision coding. Reported cases of distal pole (S62.01), waist (S62.02), and proximal pole (S62.03) were included. This data was then queried to determine trends in mechanism of injury, demographic information, and associated injuries. There were a total of 968,665 patients with 2,769 cases of reported scaphoid fractures resulting in 286 scaphoid fractures per 100,000 person-years. Males were more likely to sustain a scaphoid fracture than females. The most commonly encountered associated injuries were distal radius fractures, distal ulnar fractures, and nonscaphoid carpal bone fractures, respectively. Scaphoid fractures presenting to trauma centers are more commonly reported among males and those involved in motor vehicle accidents or falls. Appropriate scaphoid-specific radiographic imaging should be obtained as well as wrist and elbow images to evaluate for concomitant injuries, especially distal radius fractures.
舟骨是最常发生骨折的腕骨,其诊断往往具有挑战性。骨折在初次影像学评估时常常未被发现,而且不同患者的临床表现差异很大。了解高危人群有助于医生对急性舟骨骨折做出恰当的临床诊断。
国家创伤数据库是世界上最大的创伤数据储存库。利用2016年的公共使用文件,我们通过使用国际疾病分类第十版编码,按解剖骨折部位分离出舟骨骨折。纳入报告的远端极(S62.01)、腰部(S62.02)和近端极(S62.03)骨折病例。然后对这些数据进行查询,以确定损伤机制、人口统计学信息和相关损伤的趋势。
共有968,665名患者,报告了2,769例舟骨骨折病例,每10万人年有286例舟骨骨折。男性比女性更易发生舟骨骨折。最常见的相关损伤分别是桡骨远端骨折、尺骨远端骨折和非舟骨腕骨骨折。
在创伤中心就诊的舟骨骨折病例在男性以及涉及机动车事故或跌倒的人群中更为常见。应进行适当的舟骨特异性影像学检查以及手腕和肘部的影像检查,以评估是否存在合并损伤,尤其是桡骨远端骨折。