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A review of scaphoid fracture, treatment outcomes, and consequences

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Abstract

Purpose

Scaphoid fractures are the most common carpal fracture and can lead to severe complications like carpal collapse and osteoarthritis. This study reviewed scaphoid fracture patterns, outcomes, and consequences in conservative and surgical management.

Methods

Sixty-four patients with scaphoid fracture who attended the hand clinic at King Hussein Medical City from January 2022 to December 2022 were included and reviewed regarding the anatomical fracture site, the associated injury, the treatment modality (conservative versus surgical), the healing time, and fracture sequelae such as nonunion and scaphoid nonunion advanced collapse.

Results

Most patients were males (62 patients, 96.9%), and most (47, 73.4%) fell within 25 to 40 years. Scaphoid waist fracture was the most common location (40, 52.5%). Most patients (47, 73.4%) received conservative treatment and 17 (26.6%) were fixed acutely. However, nonunion complicated 53 fractures (82.8%).

Notably, there were no differences in the union rate or time between cases of scaphoid nonunion treated with vascularized or nonvascularized grafts. Furthermore, there were no variations in union rates among genders, extremities, age, fracture locations, or among smokers. However, a higher union rate was noted in office workers and those who received conservative treatment.

Conclusion

Nonunions were higher in our study than in the literature, as our department is a referral center for established nonunion cases. For conservative treatment, we recommend aggressive management and follow-up with a clinical and CT scan at three months and early referral of non-united fractures to the hand clinic to avoid the advanced collapse of the scaphoid.

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Data Availability

Available upon request.

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Author information

Authors and Affiliations

  1. Department of Hand and Upper Limb Surgery, Department of Orthopedic, King Hussein Medical City, King Abdullah II St, Amman, 230, Jordan

    Ahmad Almigdad, Ahmad Al-Zoubi, Ayman Mustafa, Motaz Al-Qasaimeh, Ehab Azzam, Saab Mestarihi, Yousef Khair & Ghandi Almanasier

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  1. Ahmad Almigdad
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  2. Ahmad Al-Zoubi
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  3. Ayman Mustafa
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  4. Motaz Al-Qasaimeh
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  5. Ehab Azzam
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  6. Saab Mestarihi
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  7. Yousef Khair
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  8. Ghandi Almanasier
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Contributions

All authors contributed to the study conception and design, material preparation, data collection, and analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ahmad Almigdad.

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This study has been approved by the local ethical committee of the Jordanian Royal Medical Services under study ID: RMS 6-2022.

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The authors declare no competing interests.

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Almigdad, A., Al-Zoubi, A., Mustafa, A. et al. A review of scaphoid fracture, treatment outcomes, and consequences. International Orthopaedics (SICOT) 48, 529–536 (2024). https://doi.org/10.1007/s00264-023-06014-2

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  • DOI: https://doi.org/10.1007/s00264-023-06014-2

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