CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2020; 48(02): 109-118
DOI: 10.1055/s-0040-1718457
Update Article | Artículo de Actualización

Diagnostic and Therapeutic Approach to Acute Scaphoid Fractures

Article in several languages: English | español
Fernando Polo Simón
1  Hand Surgery and Microsurgery Unit, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
2  Mutua Universal, Madrid, Spain
3  Orthopedic Surgery and Traumatology Service, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
,
Belén García Medrano
1  Hand Surgery and Microsurgery Unit, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
3  Orthopedic Surgery and Traumatology Service, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
,
Pedro J. Delgado Serrano
1  Hand Surgery and Microsurgery Unit, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
3  Orthopedic Surgery and Traumatology Service, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
› Author Affiliations

Abstract

The scaphoid is the carpal bone that most often fractures, accounting for up to 70% of carpal fractures and 11% of hand fractures. It is the second most common arm fracture, only surpassed by fractures of the distal radius. Despite being so common, these fractures can be difficult to diagnose and treat due to the anatomic and physiological particularities of the bone, including its precarious vascularization, its complex three-dimensional structure, and its ligament connections, which greatly contribute to the risk of complications such as malunion, pseudoarthrosis and avascular necrosis. Although there are many published studies on the treatment of these injuries, there is still controversy over what is the most suitable one for certain fracture types. The present article is a comprehensive and updated review of the literature. Combining strategies for clinical and radiological diagnosis, we propose a complete algorithm for the diagnosis of scaphoid fractures based on the varying availability of resources, and we also describe the most appropriate therapeutic approach for the different types of acute fractures of this bone.



Publication History

Received: 01 April 2020

Accepted: 27 July 2020

Publication Date:
24 November 2020 (online)

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