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

Artikel in mehreren Sprachen: 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
› Institutsangaben

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.



Publikationsverlauf

Eingereicht: 01. April 2020

Angenommen: 27. Juli 2020

Artikel online veröffentlicht:
24. November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Papp S. Carpal bone fractures. Hand Clin 2010; 26 (01) 119-127
  • 2 Sendher R, Ladd AL. The scaphoid. Orthop Clin North Am 2013; 44 (01) 107-120
  • 3 Tait MA, Bracey JW, Gaston RG. Acute scaphoid fractures. A critical analysis review. JBJS Rev 2016; 4 (09) e3
  • 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 Langer MF, Unglaub F, Breiter S, Ueberberg J, Wieskötter B, Oeckenpöhler S. [Anatomy and pathobiomechanics of the scaphoid]. Unfallchirurg 2019; 122 (03) 170-181
  • 6 Dias J, Kantharuban S. Treatment of scaphoid fractures. Hand Clin 2017; 33 (03) 501-509
  • 7 Bindra RR. Scaphoid density by CT scan. Bucharest (Hungary): IFSSH; 2004
  • 8 Garcia-Elias M, Cooney WP, An KN, Linscheid RL, Chao EY. Wrist kinematics after limited intercarpal arthrodesis. J Hand Surg Am 1989; 14 (05) 791-799
  • 9 Gelberman RH, Menon J. The vascularity of the scaphoid bone. J Hand Surg Am 1980; 5 (05) 508-513
  • 10 Oehmke MJ, Podranski T, Klaus R. et al. The blood supply of the scaphoid bone. J Hand Surg Eur Vol 2009; 34 (03) 351-357
  • 11 Herbert TJ, Lanzetta M. Idiopathic avascular necrosis of the scaphoid. J Hand Surg [Br] 1994; 19 (02) 174-182
  • 12 Mayfield JK. Mechanism of carpal injuries. Clin Orthop Relat Res 1980; (149) 45-54
  • 13 Todd AH. Fractures of the carpal scaphoid. Br J Surg 1921; 9: 7-26
  • 14 Cobey MC, White RK. An operation for non-union of fractures of the carpal navicular. J Bone Joint Surg Am 1946; 28 (04) 757-764
  • 15 Frykman G. Fracture of the distal radius including sequelae--shoulder-hand-finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function. A clinical and experimental study. Acta Orthop Scand 1967; (Suppl. 108) 3+
  • 16 Weber ER, Chao EYS. An experimental approach to the mechanism of scaphoid waist fractures. J Hand Surg Am 1978; 3 (02) 142-148
  • 17 Sabbagh MD, Morsy M, Moran SL. Diagnosis and management of acute scaphoid fractures. Hand Clin 2019; 35 (03) 259-269
  • 18 Langhoff O, Andersen JL. Consequences of late immobilization of scaphoid fractures. J Hand Surg [Br] 1988; 13 (01) 77-79
  • 19 Mallee WH, Henny EP, van Dijk CN, Kamminga SP, van Enst WA, Kloen P. Clinical diagnostic evaluation for scaphoid fractures: a systematic review and meta-analysis. J Hand Surg Am 2014; 39 (09) 1683-1691.e2
  • 20 Suh N, Grewal R. Controversies and best practices for acute scaphoid fracture management. J Hand Surg Eur Vol 2018; 43 (01) 4-12
  • 21 Parvizi J, Wayman J, Kelly P, Moran CG. Combining the clinical signs improves diagnosis of scaphoid fractures. A prospective study with follow-up. J Hand Surg [Br] 1998; 23 (03) 324-327
  • 22 Duckworth AD, Buijze GA, Moran M. et al. Predictors of fracture following suspected injury to the scaphoid. J Bone Joint Surg Br 2012; 94 (07) 961-968
  • 23 Turan A, Kose O, Aktan C, Unal M, Acar B, Sindel M. Radiographic analysis of anatomic risk factors for scaphoid fractures; A case-control study. Clin Imaging 2018; 51: 341-346
  • 24 Amrami KK, Frick MA, Matsumoto JM. Imaging for acute and chronic scaphoid fractures. Hand Clin 2019; 35 (03) 241-257
  • 25 Leslie IJ, Dickson RA. The fractured carpal scaphoid. Natural history and factors influencing outcome. J Bone Joint Surg Br 1981; 63-B (02) 225-230
  • 26 Lenoir H, Coulet B, Lazerges C, Mares O, Croutzet P, Chammas M. Idiopathic avascular necrosis of the scaphoid: 10 new cases and a review of the literature. Indications for Preiser's disease. Orthop Traumatol Surg Res 2012; 98 (04) 390-397
  • 27 Murthy NS. The role of magnetic resonance imaging in scaphoid fractures. J Hand Surg Am 2013; 38 (10) 2047-2054
  • 28 Kwee RM, Kwee TC. Ultrasound for diagnosing radiographically occult scaphoid fracture. Skeletal Radiol 2018; 47 (09) 1205-1212
  • 29 Pache G, Krauss B, Strohm P. et al. Dual-energy CT virtual noncalcium technique: detecting posttraumatic bone marrow lesions--feasibility study. Radiology 2010; 256 (02) 617-624
  • 30 Fowler JR, Hughes TB. Scaphoid fractures. Clin Sports Med 2015; 34 (01) 37-50
  • 31 Ten Berg PW, Drijkoningen T, Strackee SD, Buijze GA. Classifications of acute scaphoid fractures: a systematic literature review. J Wrist Surg 2016; 5 (02) 152-159
  • 32 Russe O. Fracture of the carpal navicular. Diagnosis, non-operative treatment, and operative treatment. J Bone Joint Surg Am 1960; 42-A: 759-768
  • 33 Cooney WP, Dobyns JH, Linscheid RL. Fractures of the scaphoid: a rational approach to management. Clin Orthop Relat Res 1980; (149) 90-97
  • 34 Herbert TJ, Fisher WE. Management of the fractured scaphoid using a new bone screw. J Bone Joint Surg Br 1984; 66 (01) 114-123
  • 35 Prosser AJ, Brenkel IJ, Irvine GB. Articular fractures of the distal scaphoid. J Hand Surg [Br] 1988; 13 (01) 87-91
  • 36 Grewal R, Suh N, Macdermid JC. Use of computed tomography to predict union and time to union in acute scaphoid fractures treated nonoperatively. J Hand Surg Am 2013; 38 (05) 872-877
  • 37 Al-Ajmi TA, Al-Faryan KH, Al-Kanaan NF. et al. A systematic review and meta-analysis of randomized controlled trials comparing surgical versus conservative treatments for acute undisplaced or minimally-displaced scaphoid fractures. Clin Orthop Surg 2018; 10 (01) 64-73
  • 38 Doornberg JN, Buijze GA, Ham SJ, Ring D, Bhandari M, Poolman RW. Nonoperative treatment for acute scaphoid fractures: a systematic review and meta-analysis of randomized controlled trials. J Trauma 2011; 71 (04) 1073-1081
  • 39 Dias JJ. Definition of union after acute fracture and surgery for fracture nonunion of the scaphoid. J Hand Surg [Br] 2001; 26 (04) 321-325
  • 40 Guss MS, Mitgang JT, Sapienza A. Scaphoid healing required for unrestrited activity: a biomechanical cadaver model. J Hand Surg Am 2018; 43 (02) 134-138
  • 41 Ram AN, Chung KC. Evidence-based management of acute nondisplaced scaphoid waist fractures. J Hand Surg Am 2009; 34 (04) 735-738
  • 42 Jernigan EW, Morse KW, Carlson MG. Managing the athlete with scaphoid fracture. Hand Clin 2019; 35 (03) 365-371
  • 43 Gupta V, Rijal L, Jawed A. Managing scaphoid fractures. How we do it?. J Clin Orthop Trauma 2013; 4 (01) 3-10
  • 44 Xiao ZR, Xiong G. Computer-assisted surgery for scaphoid fracture. Curr Med Sci 2018; 38 (06) 941-948
  • 45 Liu B, Wu F, Chen S, Jiang X, Tian W. Robot-assisted percutaneous scaphoid fracture fixation: a report of ten patients. J Hand Surg Eur Vol 2019; 44 (07) 685-691
  • 46 Salabi V, Rigoulot G, Sautet A, Cambon-Binder A. Three-dimensional-printed patient-specific Kirschner-wire guide for percutaneous fixation of undisplaced scaphoid fractures: a cadaveric study. J Hand Surg Eur Vol 2019; 44 (07) 692-696
  • 47 Geissler WB, Hammit MD. Arthroscopic aided fixation of scaphoid fractures. Hand Clin 2001; 17 (04) 575-588 , viii