gms | German Medical Science

Objectives/Interrogation: Scaphoid fractures are relatively uncommon in children, even more so in children in the first decade. The average age group for the ossification of the scaphoid bone to start is 4-6 years which goes through until 13-15 years of age. Due to the ongoing ossification of the carpal bones, diagnosing scaphoid fractures is challenging. The aim of our study was to report our experience with managing scaphoid fracture from a tertiary paediatric hand and upper limb trauma centre comprising of age group till ten years.

Methods: An analysis of prospectively collected data was done. The cases of scaphoid fractures in children up to the age of 10 years, treated in our hospital from January 2014 to June 2018 were included in the study. Parameters studied were patient demographics, clinical presentation, mechanism of injury, investigations, type of fracture, associated injuries, treatment offered, outcomes and complications if any were documented.

Results and Conclusions: Total 24 patients with documented scaphoid fractures in children up to the age of 10 years were included. The mean age was 9.79 years, with female preponderance. The most common cause of injury was accidental fall on outstretched hand, followed by sport activities and road traffic accidents. The most common location of fracture was the distal pole (10 patients) and waist (9 patients). Four patients had associated injury of capitate bone. None of the patients needed surgery; all of them were managed conservatively. No major complications noticed. The patients had to make an average of 4.33 visits for consultation and review before discharge. The average time of immobilisation was 6.67 weeks (Range: 4-10 weeks).

The incidence of scaphoid fractures in the skeletally immature age is relatively low however it is increasing due to active contact sport activities in children. The early detection and low threshold of high resolution of imaging makes detection of these fractures easier. In the very young age group of up to 10 years, when the cartilaginous portion of the scaphoid dominates, majority fractures healed well with plain immobilisation with minimal to no complications. Surgery is rarely required.