Changing patterns of scaphoid fractures in adolescents.

OBJECTIVE

To determine if the presentation of scaphoid fractures in children has changed.

DESIGN

Case study with a minimum follow-up of 1 year.

SETTING

Outpatient orthopedic clinic in an urban pediatric hospital.

PATIENTS

Twenty-one adolescents (mean age 13.9 years) with scaphoid fractures and an open distal radial growth plate. Fracture healing was assessed at 2-week intervals until union was achieved.

INTERVENTIONS

Immobilization in a short-arm thumb spica cast.

MAIN OUTCOME MEASURES

Fracture union as defined by the absence of pain and obliteration of the fracture line. Active and passive range of motion of wrist as measured with a goniometer.

RESULTS

Only 2 of the 21 patients had avulsed fractures. Twelve fractures were located in the middle one-third of the scaphoid. All fractures healed, but two fractures were in a dorsiflexed position. All patients had full, painless range of wrist motion. No arthrosis was present.

CONCLUSIONS

The presentation of scaphoid fractures in adolescents has changed over the years and now resembles the adult pattern. Malunited scaphoid fractures may be seen. Displaced fractures should be reduced.