gms | German Medical Science

Objectives/Interrogation: The epidemiology of scaphoid fractures is described only in limited populations and incidence reports are inconsistent. We investigated the nationwide incidence of scaphoid fractures in Sweden 2006-2015.

Methods: Registry data on 34377 patients with a reported scaphoid fracture were evaluated regarding diagnosis, age, sex and treatment. The data was validated by assessing radiographs and medical journals of 300 random patients and incidence rates were adjusted accordingly. The risk for a diagnosed nonunion up to 5-9 years after a scaphoid fracture was analyzed in patients with a scaphoid facture 2006-2010.

Results: A large proportion (41%) of the recorded scaphoid fractures could not be confirmed (i.e. had a false positive diagnosis). The overall adjusted incidence rate was 22 per 100 person-years. The incidence peaked at 15 years of age in both gender. There was a small but statistically significant decrease in the overall incidence rate in men during the study period. Particularly, the incidence rate decreased in men 20-24 years. 5,3% of the scaphoid fractures had acute surgery, so the vast majority was treated with a plaster cast. Men received surgical treatment to a greater degree than women (6,4 vs. 2,9%). The rate of surgery did not change during the studied period. The risk for a diagnosed nonunion within 5-9 years after a scaphoid fracture was 4,7% for men and 1,4% for women.

Conclusions: The proportion of false positive diagnoses of scaphoid fractures in the Swedish national patient register is high. Scaphoid fractures have decreased in young men. The rate of surgical treatment of scaphoid fractures is higher in men compared to women. Men are more likely to develop a scaphoid nonunion than women.