Our experience in treating scaphoid fractures in immature skeleton.

1. Scaphoid fractures in children –
our experience
Gajdobranski Đ, Živanović D, Mikov A, Slavković A,
Marić D, Marjanović Z, Milankov V

2. Anatomy
Carpal bones
„Scaphos“ = boat
Wrist joint
Parts
Vascularization
Površna grana
radijalne arterije
Radijalna
arterija
Dorzalna
skafoidna grana
Volarna
skafoidna grana

3. Fracture characteristics
0,4%2,9% Younger Teenagers
Low intensity trauma
Distal part
Unicortical
Without dislocation

4. Diagnostic procedure
Clinical examination
Edema and hematoma
Pain
Grip strength
Stress tests

5. Radiological analysis
Radiography
MRI
CT
Bone scan

6. Scaphoidseries
PA with ulnar
deviation
Profile
Oblique
Scaphoid
projection

7. Radiological analysis
Radiography
MRI
CT
Bone scan

8. Treatment
Conservative
Operative

9. Materials and methods
Retrospective study (2002 - 2010)
34 patients
Closed fractures, open physial plates
History, Clinical examination, Radiological analysis
Mayo Wrist Score

10. Results

11. Age
13,2 years
(9-15 years)
N=34

12. M Ž
Sex
distribution
79%
21%
M
F

13. Affected
side
L
R
74%
26%
82% Dominant hand

14. Mechanism of
injury
Fall
76%
Direct blow
18%
Traffic accident
3%
Unknown
3%

15. Initial radiological
finding
27
4
4
0
1
0 5 10 15 20 25 30
Positive
Suspected
Confirmed
Negative
Missed

16. Fracture
location
65% - 22 patients
35% - 12 patients
0%
3 chronic fractures

17. Acute fracture
treatment
90% 10%
4 - 8 weeks
+ 6 - 8 weeks
+ magnetotherapy
7weeks average

18. Outcome of treatment
6 lost to follow-up
Average follow-up period 3,5 months
Mayo Wrist Score – all patients – excellent (90 -100)
No Refractures or Avascular Necrosis

19. Conclusions
Conservative treatment of scaphoid fractures in children yields excellent results and is
optimal treatment for this age group.
Patients with delayed fracture union, treated with prolonged immobilization and
magnetotherapy leads to complete healing.

20. Thank You