C Stanciu1, A Dumont. 1. Division of Orthopedic Surgery, Sainte-Justine Hospital, Montreal, Que.
Abstract
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.
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.