J Wrist Surg 2022; 11(01): 089-094
DOI: 10.1055/s-0041-1726308
Survey or Meta-analysis

Effective Treatment of Simultaneous Distal Radius and Scaphoid Fractures

Julia Blackburn
1   The Pulvertaft Hand Centre, Royal Derby Hospital, Derby, United Kingdom
,
Nick Johnson
1   The Pulvertaft Hand Centre, Royal Derby Hospital, Derby, United Kingdom
,
Sasa Pocnetz
1   The Pulvertaft Hand Centre, Royal Derby Hospital, Derby, United Kingdom
,
Tommy R. Lindau
1   The Pulvertaft Hand Centre, Royal Derby Hospital, Derby, United Kingdom
› Author Affiliations

Abstract

Background There is an increasing trend for most surgeons to choose open reduction and internal fixation of simultaneous distal radius and scaphoid fractures; however, it is not clear if there is any evidence to support this.

Case Description The purpose of this systematic review was to investigate the evidence for management of simultaneous distal radius and scaphoid fractures.

Literature Review We performed searches of the EMBASE and MEDLINE databases (CRD42020167403). We included a total of 20 studies, involving 178 patients with 182 simultaneous fractures of the distal radius and scaphoid. The distal radius fractures were mostly intra-articular (112/182). The scaphoid fractures were mostly undisplaced (120/148) and at the scaphoid waist (152/178). All distal radius fractures went on to unite, and just 2 of 182 scaphoid fractures went on to nonunion. All included studies were retrospective case series, and therefore all were found to have a critical risk of bias due to confounding. The union rate for both the distal radius and scaphoid fractures is high with both operative and nonoperative treatments.

Clinical Relevance Although there are no comparative studies to evaluate the most effective treatment, there is evidence to support operative management.

Level of Evidence This is a Level IV, systematic review study.



Publication History

Received: 23 June 2020

Accepted: 03 February 2021

Article published online:
24 March 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 MacIntyre NJ, Dewan N. Epidemiology of distal radius fractures and factors predicting risk and prognosis. J Hand Ther 2016; 29 (02) 136-145
  • 2 Stirling ERB, Johnson NA, Dias JJ. Epidemiology of distal radius fractures in a geographically defined adult population. J Hand Surg Eur Vol 2018; 43 (09) 974-982
  • 3 Swärd EM, Schriever TU, Franko MA, Björkman AC, Wilcke MK. The epidemiology of scaphoid fractures in Sweden: a nationwide registry study. J Hand Surg Eur Vol 2019; 44 (07) 697-701
  • 4 Van Tassel DC, Owens BD, Wolf JM. Incidence estimates and demographics of scaphoid fracture in the U.S. population. J Hand Surg Am 2010; 35 (08) 1242-1245
  • 5 Hove LM. Simultaneous scaphoid and distal radius fractures. J Hand Surg Br 1994; 19 (03) 384-388
  • 6 Chang CH, Tsai YS, Sun JS, Hou SM. Ipsilateral distal radius and scaphoid fractures. J Formos Med Assoc 2000; 99 (09) 733-737
  • 7 Fowler TP, Fitzpatrick E. Simultaneous fractures of the ipsilateral scaphoid and distal radius. J Wrist Surg 2018; 7 (04) 303-311
  • 8 Komura S, Yokoi T, Nonomura H, Tanahashi H, Satake T, Watanabe N. Incidence and characteristics of carpal fractures occurring concurrently with distal radius fractures. J Hand Surg Am 2012; 37 (03) 469-476
  • 9 Vukov V, Ristić K, Stevanović M, Bumbasirević M. Simultaneous fractures of the distal end of the radius and the scaphoid bone. J Orthop Trauma 1988; 2 (02) 120-123
  • 10 Stother IG. A report of 3 cases of simultaneous Colles' and scaphoid fractures. Injury 1976; 7 (03) 185-188
  • 11 Chrisman OD, Shortell JH. Fractures of the distal end of the radius complicated by fractures of the carpal scaphoid. N Engl J Med 1949; 241 (02) 58-59
  • 12 Gürbüz Y, Sügün TS, Kayalar M. Combined fractures of the scaphoid and distal radius: evaluation of early surgical fixation (21 patients with 22 wrists). J Wrist Surg 2018; 7 (01) 11-17
  • 13 Stober R, Wohlgensinger G. [Concomitant carpal injuries in radius fractures. Nature and incidence, analysis of the last 10 years] (in German). Z Unfallchir Versicherungsmed Berufskr 1989; 82 (01) 63-65
  • 14 Gologan R, Ginter VM, Ising N, Kilian AK, Obertacke U, Schreiner U. [Carpal lesions associated with dislocated fractures of the distal radius. A systematic screening of 104 fractures using preoperative CT and MRI] (in German). Unfallchirurg 2014; 117 (01) 48-53
  • 15 Herzberg G, Comtet JJ, Linscheid RL, Amadio PC, Cooney WP, Stalder J. Perilunate dislocations and fracture-dislocations: a multicenter study. J Hand Surg Am 1993; 18 (05) 768-779
  • 16 Sterne JA, Hernán MA, Reeves BC. et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016; 355: i4919
  • 17 Campbell M, McKenzie JE, Sowden A. et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ 2020; 368: l6890
  • 18 Dias J, Singh H. Instructional review: upper limb. displaced fracture of the waist of the scaphoid. J Bone Joint Surg 2011; 93 (11) 1433-1439
  • 19 Dias J, Brealey S, Choudhary S. et al. Scaphoid Waist Internal Fixation for Fractures Trial (SWIFFT) protocol: a pragmatic multi-centre randomised controlled trial of cast treatment versus surgical fixation for the treatment of bi-cortical, minimally displaced fractures of the scaphoid waist in adults. BMC Musculoskelet Disord 2016; 17: 248
  • 20 Eastley N, Singh H, Dias JJ, Taub N. Union rates after proximal scaphoid fractures; meta-analyses and review of available evidence. J Hand Surg Eur Vol 2013; 38 (08) 888-897
  • 21 Kristiansen B. [Simultaneous Colle's fracture and fracture of the carpal scaphoid] (in Danish). Ugeskr Laeger 1982; 144 (11) 799
  • 22 Jenkins NH, Jones DG. Simultaneous Colles' and scaphoid fractures: treatment by combined internal and external fixation. Am J Emerg Med 1986; 4 (03) 229-230
  • 23 Oskam J, De Graaf JS, Klasen HJ. Fractures of the distal radius and scaphoid. J Hand Surg [Br] 1996; 21 (06) 772-774
  • 24 Ozkan K, Ugutmen E, Unay K, Poyanli O, Guven M, Eren A. Fractures of the bilateral distal radius and scaphoid: a case report. J Med Case Reports 2008; 2: 93
  • 25 Møller BN. Simultaneous fracture of the carpal scaphoid and adjacent bones. Hand 1983; 15 (03) 258-261
  • 26 Tountas AA, Waddell JP. Simultaneous fractures of the distal radius and scaphoid. J Orthop Trauma 1987; 1 (04) 312-317
  • 27 Richards RR, Ghose T, McBroom RJ. Ipsilateral fractures of the distal radius and scaphoid treated by Herbert screw and external skeletal fixation. A report of two cases. Clin Orthop Relat Res 1992; (282) 219-221
  • 28 Helm RH, Tonkin MA. The chauffeur's fracture: simple or complex?. J Hand Surg [Br] 1992; 17 (02) 156-159
  • 29 Trumble TE, Benirschke SK, Vedder NB. Ipsilateral fractures of the scaphoid and radius. J Hand Surg Am 1993; 18 (01) 8-14
  • 30 Rutgers M, Mudgal CS, Shin R. Combined fractures of the distal radius and scaphoid. J Hand Surg Eur Vol 2008; 33 (04) 478-483
  • 31 Smith JT, Keeve JP, Bertin KC, Mann RJ. Simultaneous fractures of the distal radius and scaphoid. J Trauma 1988; 28 (05) 676-679
  • 32 Slade III JF, Taksali S, Safanda J. Combined fractures of the scaphoid and distal radius: a revised treatment rationale using percutaneous and arthroscopic techniques. Hand Clin 2005; 21 (03) 427-441
  • 33 Proubasta IR, Lluch AL. Concomitant fractures of the scaphoid and the distal end of the radius: treatment by external fixation. J Bone Joint Surg Am 1991; 73 (06) 938-940