Skip to main content
PMC home page
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 2001 Apr;77(906):235–237. doi: 10.1136/pmj.77.906.235

Review of the current methods in the diagnosis and treatment of scaphoid fractures

E Krasin 1, M Goldwirth 1, A Gold 1, D Goodwin 1
PMCID: PMC1741990  PMID: 11264484

Abstract

If neglected or misdiagnosed, non-union of a scaphoid fracture will almost inevitably progress to radiographic and symptomatic osteoarthritis of the wrist with subsequent morbidity and lifelong disability, especially in young males in which the fracture is more common. Fractures of the scaphoid bone are the most common fractures of the carpus and second in occurrence among fractures of the wrist.
The diagnosis and treatment are not simple. Familiarity with different imaging methods and treatment options is required. The treatment in most cases is conservative and will lead to uneventful union, but an operation may be needed in certain cases primarily and in the treatment of non-union.
The current literature on the diagnosis and treatment of scaphoid fractures is reviewed, and the authors try to make a clear and concise picture of this complex and sometimes controversial field.


Keywords: scaphoid; fracture

Full Text

The Full Text of this article is available as a PDF (97.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barton N. J. Twenty questions about scaphoid fractures. J Hand Surg Br. 1992 Jun;17(3):289–310. doi: 10.1016/0266-7681(92)90118-l. [DOI] [PubMed] [Google Scholar]
  2. Bynum E. B., Culp R. W., Bonatus T. J., Alexander C. E., McCarroll H. R. Repeat Russe bone grafting after failed bone graft surgery for scaphoid non-union. J Hand Surg Br. 1995 Jun;20(3):373–378. doi: 10.1016/s0266-7681(05)80096-8. [DOI] [PubMed] [Google Scholar]
  3. Hambidge J. E., Desai V. V., Schranz P. J., Compson J. P., Davis T. R., Barton N. J. Acute fractures of the scaphoid. Treatment by cast immobilisation with the wrist in flexion or extension? J Bone Joint Surg Br. 1999 Jan;81(1):91–92. doi: 10.1302/0301-620x.81b1.9367. [DOI] [PubMed] [Google Scholar]
  4. Hunter J. C., Escobedo E. M., Wilson A. J., Hanel D. P., Zink-Brody G. C., Mann F. A. MR imaging of clinically suspected scaphoid fractures. AJR Am J Roentgenol. 1997 May;168(5):1287–1293. doi: 10.2214/ajr.168.5.9129428. [DOI] [PubMed] [Google Scholar]
  5. Inoue G., Kuwahata Y. Repeat screw stabilization with bone grafting after a failed Herbert screw fixation for acute scaphoid fractures and nonunions. J Hand Surg Am. 1997 May;22(3):413–418. doi: 10.1016/S0363-5023(97)80007-X. [DOI] [PubMed] [Google Scholar]
  6. Leslie I. J., Dickson R. A. The fractured carpal scaphoid. Natural history and factors influencing outcome. J Bone Joint Surg Br. 1981 Aug;63-B(2):225–230. doi: 10.1302/0301-620X.63B2.7217146. [DOI] [PubMed] [Google Scholar]
  7. Lindström G., Nyström A. Natural history of scaphoid non-union, with special reference to "asymptomatic" cases. J Hand Surg Br. 1992 Dec;17(6):697–700. doi: 10.1016/0266-7681(92)90204-f. [DOI] [PubMed] [Google Scholar]
  8. Mehta M., Brautigan M. W. Fracture of the carpal navicular--efficacy of clinical findings and improved diagnosis with six-view radiography. Ann Emerg Med. 1990 Mar;19(3):255–257. doi: 10.1016/s0196-0644(05)82039-6. [DOI] [PubMed] [Google Scholar]
  9. Mintzer C. M., Waters P. M. Surgical treatment of pediatric scaphoid fracture nonunions. J Pediatr Orthop. 1999 Mar-Apr;19(2):236–239. doi: 10.1097/00004694-199903000-00020. [DOI] [PubMed] [Google Scholar]
  10. Murphy D. G., Eisenhauer M. A., Powe J., Pavlofsky W. Can a day 4 bone scan accurately determine the presence or absence of scaphoid fracture? Ann Emerg Med. 1995 Oct;26(4):434–438. doi: 10.1016/s0196-0644(95)70110-9. [DOI] [PubMed] [Google Scholar]
  11. Parvizi J., Wayman J., Kelly P., Moran C. G. Combining the clinical signs improves diagnosis of scaphoid fractures. A prospective study with follow-up. J Hand Surg Br. 1998 Jun;23(3):324–327. doi: 10.1016/s0266-7681(98)80050-8. [DOI] [PubMed] [Google Scholar]
  12. Tiel-van Buul M. M., van Beek E. J., Borm J. J., Gubler F. M., Broekhuizen A. H., van Royen E. A. The value of radiographs and bone scintigraphy in suspected scaphoid fracture. A statistical analysis. J Hand Surg Br. 1993 Jun;18(3):403–406. doi: 10.1016/0266-7681(93)90074-p. [DOI] [PubMed] [Google Scholar]
  13. Whipple T. L. Stabilization of the fractured scaphoid under arthroscopic control. Orthop Clin North Am. 1995 Oct;26(4):749–754. [PubMed] [Google Scholar]
  14. Wulff R. N., Schmidt T. L. Carpal fractures in children. J Pediatr Orthop. 1998 Jul-Aug;18(4):462–465. [PubMed] [Google Scholar]
  15. Yang Z. Y., Gilula L. A., Jonsson K. Os centrale carpi simulating a scaphoid waist fracture. J Hand Surg Br. 1994 Dec;19(6):754–756. doi: 10.1016/0266-7681(94)90252-6. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES