W Yinusa1, O Adetan, D O Odatuwa-Omagbemi, M U Eyo. 1. Department of Trauma and Orthopaedic Surgery, National Orthopaedic Hospital Igbobi, Lagos, Nigeria. boboyinus@yahoo.com
Abstract
BACKGROUND: The scaphoid is the most prominent of the carpal bones in the first row and the most frequently fractured of all the carpal bones. Bilateral simultaneous scaphoid fractures are uncommon. OBJECTIVE: To report bilateral simultaneous fractures of the carpal scaphoid bones and their successful treatment with bilateral thumb spica casts METHODS: A 28-year-old medical practitioner presented with a day history of painful swollen wrists following a fall on both outstretched hands. He was fully examined and had both wrists X-rayed. He was subsequently treated with bilateral below elbow thumb spica POP cast. RESULTS: He had previously been healthy until this fall. Physical examination showed a healthy looking young man in pain. There were swelling and tenderness over both anatomical snuff boxes with associated limitation of movements at the wrists. X-rays revealed an undisplaced scaphoid wrist fracture and proximal pole fracture on the right and left respectively. He was successfully treated with bilateral below elbow thumb spica POP cast applied over a period of eight weeks. CONCLUSION: Although recent opinions tend to favour internal fixation for bilateral simultaneous fractures of the scaphoid bones to avoid prolonged cast immobilization and loss of man hours at work, they can be successfully treated with conservative cast immobilisation with comparatively early return to full activity.
BACKGROUND: The scaphoid is the most prominent of the carpal bones in the first row and the most frequently fractured of all the carpal bones. Bilateral simultaneous scaphoid fractures are uncommon. OBJECTIVE: To report bilateral simultaneous fractures of the carpal scaphoid bones and their successful treatment with bilateral thumb spica casts METHODS: A 28-year-old medical practitioner presented with a day history of painful swollen wrists following a fall on both outstretched hands. He was fully examined and had both wrists X-rayed. He was subsequently treated with bilateral below elbow thumb spica POP cast. RESULTS: He had previously been healthy until this fall. Physical examination showed a healthy looking young man in pain. There were swelling and tenderness over both anatomical snuff boxes with associated limitation of movements at the wrists. X-rays revealed an undisplaced scaphoid wrist fracture and proximal pole fracture on the right and left respectively. He was successfully treated with bilateral below elbow thumb spica POP cast applied over a period of eight weeks. CONCLUSION: Although recent opinions tend to favour internal fixation for bilateral simultaneous fractures of the scaphoid bones to avoid prolonged cast immobilization and loss of man hours at work, they can be successfully treated with conservative cast immobilisation with comparatively early return to full activity.