J Korean Fract Soc.
1994 Nov;7(2):371-378.
A Diagnosis and Treatment of Carpal Scaphoid Fractures
- Affiliations
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- 1Department of Orthopaedic surgery, Hae-Dong Hospital, Pusan, Korea.
Abstract
- The scaphoid fracture is the most common fracture in carpal bones. Its diagnosis is very difficult because of less symptoms and swelling. But unfortunately its complications such as nonunion, avascular necrosis, and osteoarthritis were severe. We reviewed 27 cases of the carpal scaphoid fractures treated from March 1989 to March 1993 in Hae-Dong hospital and obtained following results. 1. The highest peak was third and forth decades. 24 cases were male among 27 cases. The most common cause of fracture was outstretched hand injury. 2. The middle third was the most common location(60%) and transverse type fractures were 12 cases(75%) among these fractures. 3. We gained 75% bone union at average 15.4 weeks in proximal 1/3 carpal scaphoid fractures, 93% union at average 12.9 weeks in middle 1/3 fractures, and 100% union at average 11.2 weeks in distal 1/3 fractures. 4. The results of treatments were evaluated by Maudsley method. Excellent and good results were 10 of 11 cases in conservative treatment, 13 of 16 cases in operative treatment. According to fracture sites excellent, and good results were 1 of 4 cases in proximal fracture, 14 of 16 cases in middle fracture and all of 7 cases in distal. 5. The complications were 2 cases of nonunion,3 cases of avascular necrosis and 2 cases of osteoarthritis. 6. In case of delayed diagnosis, the longer duration of treatments were needed, We obtained better results in fresh, undisplaced fractures with thumb spica cast than old displaced fractures. We gained better results in displaced fractures with open reduction and bone graft than conservative methods.
