Incidence of Scaphoid Fractures and Associated Injuries at US Trauma Centers

2020 ◽  
Author(s):  
Matthew E. Wells ◽  
Tyler C. Nicholson ◽  
Reuben A. Macias ◽  
Leon J. Nesti ◽  
John C. Dunn
Keyword(s):  
Distal Radius ◽  
Motor Vehicle ◽  
Bone Fractures ◽  
Scaphoid Fracture ◽  
Distal Radius Fractures ◽  
Carpal Bone ◽  
Trauma Centers ◽  
Associated Injuries ◽  
Radius Fractures ◽  
Scaphoid Fractures

Abstract Backgound The scaphoid is the most commonly fractured carpal bone and often presents as a diagnostic challenge. Fractures can often go unnoticed on initial radiographic evaluation and clinical presentation can vary significantly among patients. Awareness of high-risk cohorts assists practitioners in making the appropriate clinical diagnosis of acute scaphoid fracture. Materials and Methods The National Trauma Data Bank is the world's largest trauma data repository. Utilizing the 2016 public use file, we isolated scaphoid fractures by anatomic fracture location by utilizing International Classification of Diseases, 10th revision coding. Reported cases of distal pole (S62.01), waist (S62.02), and proximal pole (S62.03) were included. This data was then queried to determine trends in mechanism of injury, demographic information, and associated injuries. Results There were a total of 968,665 patients with 2,769 cases of reported scaphoid fractures resulting in 286 scaphoid fractures per 100,000 person-years. Males were more likely to sustain a scaphoid fracture than females. The most commonly encountered associated injuries were distal radius fractures, distal ulnar fractures, and nonscaphoid carpal bone fractures, respectively. Conclusions Scaphoid fractures presenting to trauma centers are more commonly reported among males and those involved in motor vehicle accidents or falls. Appropriate scaphoid-specific radiographic imaging should be obtained as well as wrist and elbow images to evaluate for concomitant injuries, especially distal radius fractures.

scholarly journals Simultaneous Fractures of the Ipsilateral Scaphoid and Distal Radius

2018 ◽  
Vol 07 (04) ◽  
pp. 303-311 ◽  
Author(s):  
Elizabeth Fitzpatrick ◽  
Timothy Fowler
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Scaphoid Fracture ◽  
High Energy ◽  
Fracture Pattern ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Radius Fractures ◽  
Scaphoid Fractures

Background Ipsilateral fractures of the distal radius and scaphoid are rare, with few reports describing mechanisms of injury, fracture patterns, and treatment approaches. Purpose This article describes the clinical and radiographic features of ipsilateral distal radius and scaphoid fractures occurring simultaneously. Materials and Methods Electronic databases from 2007 to 2017 at a single Level 1 trauma center were reviewed for patients with concurrent fractures of the distal radius and scaphoid. Patient demographics, injury mechanism, scaphoid and distal radius fracture pattern, treatment approach, and radiographic healing were studied. Results Twenty-three patients were identified. Nineteen of the 23 (83%) were males, and 19 of 23 (83%) of the injury mechanisms were considered high energy. Twenty-two of the 23 (96%) scaphoid fractures were nondisplaced, all treated with screw fixation. Most distal radius fractures were displaced and comminuted, 17 of 23 (74%) were intra-articular. All distal radius fractures were treated surgically with internal and/or external fixation. Three patients were lost to follow-up. Average follow-up of the remaining 20 was to 19.8 weeks. Nineteen of the 20 (95%) scaphoids healed, one scaphoid went on to nonunion with avascular necrosis. All 20 radius fractures healed, 16 of 20 (80%) in anatomic alignment. Conclusion Ipsilateral fractures of the distal radius and scaphoid are rare and are usually result of high-energy mechanisms. The scaphoid fracture is usually a nondisplaced fracture at the waist. The distal radius fracture pattern varies but most are displaced and comminuted. The union rate of the scaphoid is high, even if subjected to radiocarpal distraction required for distal radius management. Level of Evidence Therapeutic level IV study.

scholarly journals Extensor Tendon Entrapment on Computed Tomography Imaging of Distal Radius Fractures

2019 ◽  
Vol 09 (02) ◽  
pp. 129-135
Author(s):  
Evan D. Nigh ◽  
Christopher P. Emerson ◽  
David To ◽  
Spencer Barnhill ◽  
Michael G. Rizzo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Distal Radius ◽  
Motor Vehicle ◽  
Ct Imaging ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Extensor Pollicis Longus ◽  
Tendon Entrapment

Abstract Objective To examine the association between distal radius fractures and tendon entrapment identified on computed tomography (CT) imaging. Patients and Methods After Institutional Review Board approval, we retrospectively reviewed distal radius fractures that underwent CT imaging from an electronic database between January 2006 to February 2018 at a single level 1 hospital trauma center. We categorized all distal radial fractures according to the AO-OTA (AO Foundation/Orthopaedic Trauma Association) classification. Distal upper extremity tendons were assessed for entrapment. Fisher's exact test was used for statistical analysis with significance at p < 0.05. Results A total of 183 distal radius fractures were identified in 179 patients. A total of 16 fractures (13 males and 3 females) were associated with tendon entrapment. Mechanism of injury included falls (n = 7), motor vehicle accidents (n = 6), dog bites (n = 2), and gunshot wound (n = 1). Entrapped tendons were limited to the extensor compartment and included the extensor pollicis longus (EPL; n = 11), extensor pollicis brevis (n = 1), extensor carpi ulnaris (n = 1), extensor carpi radialis longus (n = 1), and extensor digitorum communis (n = 2). The most commonly associated AO-OTA fracture pattern with tendon entrapment was complete articular radial fractures (2R3C; 69%), eight of which were simple articular with metaphyseal multifragmentary fractures (2R3C2). Of the distal radius fractures, 81% were associated with additional ulnar fractures of varying severity and displacement. Conclusion Approximately 8.7% of distal radius fractures were retrospectively identified to have tendon entrapment compared with a previously reported incidence of 1.3%. Wrist surgeons and radiologists should have higher suspicion for tendon entrapment and carefully review preoperative CT imaging for tendon entrapment in distal radius fractures especially if there is an intra-articular, multifragmentary injury pattern. Wrist surgeons and radiologists should also have increased suspicion for EPL tendon entrapments given its high incidence in association with distal radius fractures. Level of Evidence This is a Level III, retrospective cross-sectional study.

scholarly journals Epidemiology of Distal Radius Fractures in Children and Adults During the COVID-19 Pandemic – A Two-Center Study

2020 ◽  
Author(s):  
Jarosław Olech ◽  
Mariusz Ciszewski ◽  
Piotr Morasiewicz
Keyword(s):  
Hospital Stay ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Adult Patients ◽  
Individual Treatment ◽  
Trauma Centers ◽  
Radius Fractures ◽  
Treatment Type ◽  
Number Of Patients ◽  
The Impact

Abstract Bacground: The purpose of our study was a comprehensive assessment of the impact of theCOVID-19 pandemic on distal radius fractures(DRF)epidemiology,including both children and adults and various fracture fixation methods in two large trauma centers in Poland.Methods: This study compared the data on the treatment of distal radius fractures in Poland in two periods:the period of the COVID-19 pandemic and the corresponding period prior to the pandemic.We assessed detailed data from two trauma centers for pediatric and adult patients.We compared epidemiological data,demographic data,treatment type,and hospital stay duration.Results: The total number of patients hospitalized due to DRF during the pandemic was 15.1% lower than that from the pre-COVID-19 pandemic period.In the case of adult patients, the total number of those hospitalized during the pandemic decreased significantly(by 22%) from132 to103patients.Analysis of the individual treatment methods revealed that the number of adults who underwent conservative treatment was considerably(by 30.3%)significantly lower in the period of the COVID-19 pandemic.Compared to the figures from the pre-pandemic period,the number of surgically treated adults was significantly higher(by 53.8%).Our analyses showed hospitalizations of surgically treated adults to be shorter by 12.7%during the pandemic,with the corresponding hospitalizations of surgically treated pediatric patients to be shorter by11.5%.Conclusions: Our study showed decreased numbers of pediatric and adult patients with DRFs during the COVID-19 pandemic.The pandemic caused an increase in the number of children and significantly increase adults undergoing surgical treatment for DRFs, a decrease in mean patient age,shorter significantly durations of hospital stay, and an increased number of men with DRFs.

Distal radius fracture with ipsilateral elbow dislocation: a rare but challenging injury

2021 ◽  
Author(s):  
Henrik Constantin Bäcker ◽  
Kathi Thiele ◽  
Chia H. Wu ◽  
Philipp Moroder ◽  
Ulrich Stoeckle ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Elbow Dislocation ◽  
High Energy ◽  
Low Energy ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Associated Injuries ◽  
Radius Fractures ◽  
High Energy Trauma

Abstract IntroductionDistal radius fractures are common and account for approximately 14% to 18% of all adult extremity injuries. On rare occasions, ipsilateral elbow dislocation can be observed additionally. The aim of this study was to analyse the mechanism and level of injury, demographics, and associated injuries in distal radius fractures with ipsilateral elbow dislocations.Methods:Between 2012 and 2019, we searched our trauma database for distal radius fractures with ipsilateral elbow dislocations. All patients older than 18 years old were included. Data on demographics, mechanism of injury, level of energy, and subsequent treatments were collected. ResultsA total of 7 patients were identified. The mean age was 68.7 ± 13.3 years old and the left side was involved in 71.4% of cases. Females were affected in 85.7% (n=6/7) of cases. All suffered from low-energy mechanism without other orthopaedic injuries at a mean age of 71.5 ± 12.3 years old. The one male patient that was included suffered from high-energy trauma at 52 years of age. Most commonly, posterior elbow dislocations were observed (66.7%; n=4/6). Distal radius fracture patterns include two C2, two C3, and one case each of C1-type and B1-type fracture pattern in the low energy group. In the group of patients who sustained high energy trauma, associated injuries include a concomitant open elbow dislocation, an ulnar artery rupture and damage to the flexor digitorum superficialis muscle.ConclusionAlthough distal radius fracture with ipsilateral elbow dislocation is thought to be resulting from high energy injuries, this study shows that most patients were elderly females suffering from low energy mechanisms. If not suspected, this could be missed especially in the setting of altered mental status. Careful physical examination of one joint proximal and one joint distal to the presumed site of injury is recommended.

Distraction Plating for the Treatment of Highly Comminuted Distal Radius Fractures in Elderly Patients

2013 ◽  
Vol 3 (1) ◽  
pp. 93-98
Author(s):  
Leonid I Katolik ◽  
Douglas P Hanel ◽  
Daniel A Wartinbee ◽  
David Ruch
Keyword(s):  
Elderly Patients ◽  
Distal Radius ◽  
The Elderly ◽  
Distal Radius Fractures ◽  
Dash Score ◽  
Trauma Centers ◽  
Radius Fractures ◽  
Radial Inclination ◽  
Internal Distraction

ABSTRACT Purpose To evaluate the use of internal distraction plating for the management of comminuted, intra-articular distal radius fractures in patients over 60 years of age at two level one trauma centers. Our hypothesis was that distraction plating of comminuted distal radius fractures in the elderly would result in acceptable outcomes regarding range of motion, disabilities of the arm, shoulder and hand (DASH) score, and radiographic parameters and would thereby provide the upper extremity surgeon with another option for the treatment of these fractures. Materials and methods A retrospective review was performed on 33 patients over 60 years of age with comminuted distal radius fractures treated by internal distraction plating at two level 1 trauma centers. Patients were treated with internal distraction plating across the radiocarpal joint. At the time of final follow-up, radiographs were evaluated for ulnar variance, radial inclination, and palmar tilt. Range of motion, complications and DASH scores were also obtained. Results Thirty-three patients with a mean age of 70 years were treated with distraction plating for comminuted distal radius fractures. At final follow-up, all fractures had healed and radiographs demonstrated mean palmar tilt of 5° and mean positive ulnar variance of 0.6 mm. Mean radial inclination was 20°. Mean values for wrist flexion and extension were 46° and 50° respectively. Mean pronation and supination were 79° and 77° respectively. At the final follow-up, the mean DASH score was 32. Conclusion In the elderly, distraction plating is an effective method of treatment for comminuted, osteoporotic distal radius fractures. Level of evidence Therapeutic, Level IV (Retrospective case series). Richard MJ, Katolik LI, Hanel DP, Wartinbee DA, Ruch D. Distraction Plating for the Treatment of Highly Comminuted Distal Radius Fractures in Elderly Patients. The Duke Orthop J 2013;3(1):93-98.

Scaphoid fractures

1996 ◽  
Vol 4 (3) ◽  
pp. 1-13
Author(s):  
Robert S Richards ◽  
James H Roth
Keyword(s):  
Bone Fractures ◽  
Scaphoid Fracture ◽  
Treatment Options ◽  
Carpal Bone ◽  
Working Capacity ◽  
Long Period ◽  
Scaphoid Fractures ◽  
Carpal Bone Fractures

Scaphoid fractures are the most common carpal bone fractures and present physicians with many problems. The majority of such fractures (90%) will unite if properly treated; however a scaphoid fracture that goes on to nonunion affects a patient's working capacity for a long period of time. This paper reviews the pathophysiology of the injury and outlines the diagnostic and treatment options available.

Effective Treatment of Simultaneous Distal Radius and Scaphoid Fractures

2021 ◽  
Author(s):  
Julia Blackburn ◽  
Nick Johnson ◽  
Sasa Pocnetz ◽  
Tommy R. Lindau
Keyword(s):  
Systematic Review ◽  
Effective Treatment ◽  
Distal Radius ◽  
Case Series ◽  
Operative Management ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Scaphoid Fractures

Abstract Background There is an increasing trend for most surgeons to choose open reduction and internal fixation of simultaneous distal radius and scaphoid fractures; however, it is not clear if there is any evidence to support this. Case Description The purpose of this systematic review was to investigate the evidence for management of simultaneous distal radius and scaphoid fractures. Literature Review We performed searches of the EMBASE and MEDLINE databases (CRD42020167403). We included a total of 20 studies, involving 178 patients with 182 simultaneous fractures of the distal radius and scaphoid. The distal radius fractures were mostly intra-articular (112/182). The scaphoid fractures were mostly undisplaced (120/148) and at the scaphoid waist (152/178). All distal radius fractures went on to unite, and just 2 of 182 scaphoid fractures went on to nonunion. All included studies were retrospective case series, and therefore all were found to have a critical risk of bias due to confounding. The union rate for both the distal radius and scaphoid fractures is high with both operative and nonoperative treatments. Clinical Relevance Although there are no comparative studies to evaluate the most effective treatment, there is evidence to support operative management. Level of Evidence This is a Level IV, systematic review study.

scholarly journals Conservative treatment of scaphoid fracture: Protocol for a systematic review

2022 ◽  
Vol 11 (1) ◽  
pp. e43611125220
Author(s):  
Taís Ribeiro Sousa Oliveira da Cunha ◽  
Matheus Velame de Morais ◽  
Larrie Rabelo Laporte ◽  
Cloud Kennedy Couto de Sá ◽  
Alex Guedes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Impact ◽  
Bone Fractures ◽  
Scaphoid Fracture ◽  
Plaster Cast ◽  
Carpal Bone ◽  
Cast Immobilization ◽  
Secondary Osteoarthritis ◽  
Scaphoid Fractures ◽  
Carpal Bone Fractures

The scaphoid is the most commonly fractured carpal bone. Fractures affecting this bone affect young and active patients between 15 and 40 years of age. Stable scaphoid fractures are treated conservatively by plaster cast immobilization or other type of orthosis for an average period of four to 12 weeks. Failure to treat scaphoid fractures may result in avascular necrosis, nonunion, and early secondary osteoarthritis, which may result in significant economic and social impact due to the affected population, formed by young people of productive age. The management of this type of fracture varies significantly between different Institutions and orthopedic surgeons. This article describes a protocol for a systematic review that aims to evaluate the effects (benefits and harms) of conservative interventions in the treatment of scaphoid fractures in adults.

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