Skip to main content

Diagnosis and treatment of scaphoid fractures, can non-union be prevented?

Abstract

In order to evaluate the diagnostic management of scaphoid fracture, 100 consecutive patients with clinically suspected scaphoid fractures were investigated. If a scaphoid fracture was seen on scaphoid radiographs, patients were immobilized in a plaster cast. If the radiographs were negative or dubious for scaphoid fracture, patients were referred for three phase bone scintigraphy. Then the patient was treated according to the result of the bone scan. A long-term follow-up (minimum 1 year) was performed in order to evaluate the incidence of non-union. In 49 of the 100 patients, a fracture of the scaphoid was recognized, in 29 of whom their scaphoid X-series was positive for scaphoid fracture. In 3 of the remaining 71 patients with negative scaphoid X-series, additional carpal box radiographs showed a scaphoid fracture, while 68 patients were referred for three-phase bone scintigraphy. Of these 68 patients, 17 patients (25%) showed a hotspot on the bone scan in the region of the scaphoid. We found that scaphoid radiographs, additional carpal box radiographs and the bone scan (in radiographically negative patients) in combination with conservative therapy did not lead to non-union at long-term follow-up in patients who were treated for scaphoid fracture. We conclude that when a scaphoid fracture is diagnosed within the 1st week followed by plaster immobilization, non-union of the scaphoid could be prevented.

This is a preview of subscription content, access via your institution.

Author information

Affiliations

Authors

Additional information

Received: 17 August 1998

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Roolker, W., Maas, M. & Broekhuizen, A. Diagnosis and treatment of scaphoid fractures, can non-union be prevented?. Arch Orth Traum Surg 119, 428–431 (1999). https://doi.org/10.1007/s004020050014

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004020050014

Keywords

  • Immobilization
  • Bone Scintigraphy
  • Conservative Therapy
  • Negative Patient
  • Plaster Cast