Acute scaphoid fractures: Guidelines for diagnosis and treatment

Research output: Contribution to journalArticle

Abstract

In cases of suspected scaphoid fracture where the initial radiographs are negative, a supplementary MRI, or alternatively CT, should be carried out within three to five days. Fracture classification, assessment of dislocation as well as evaluation of fracture healing is best done on CT with reconstructions in the coronal and sagittal planes, following the longitudinal axis of the scaphoid. After adequate conservative management, union is achieved at six weeks for approximately 90% of nondisplaced or minimally displaced (≤ 0.5 mm) scaphoid waist fractures. Scaphoid waist fractures with moderate displacement (0.5-1.5 mm) can be treated conservatively, but require prolonged cast immobilization for approximately eight to ten weeks. Internal fixation is recommended for all scaphoid waist fractures with dislocation ≥ 1.5 mm. Distal scaphoid fractures can be treated conservatively. The majority heal uneventfully after four to six weeks of immobilization, depending on fracture type. In general, proximal scaphoid fractures should be treated with internal fixation.

Details

Authors
Organisations
External organisations
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Orthopedics
  • Biomaterials Science

Keywords

  • Internal fixation, Non-operative treatment, Scaphoid fracture
Original languageEnglish
Pages (from-to)96-103
Number of pages8
JournalEFORT Open Reviews
Volume5
Issue number2
Publication statusPublished - 2020 Feb 3
Publication categoryResearch
Peer-reviewedYes