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Acute scaphoid fractures : Guidelines for diagnosis and treatment

Clementson, Martin LU ; Björkman, Anders LU and Thomsen, Niels O.B. LU (2020) In EFORT open reviews 5(2). p.96-103
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... (More)

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.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Internal fixation, Non-operative treatment, Scaphoid fracture
in
EFORT open reviews
volume
5
issue
2
pages
8 pages
publisher
British Editorial Society of Bone & Joint Surgery
external identifiers
  • pmid:32175096
  • scopus:85080925187
ISSN
2396-7544
DOI
10.1302/2058-5241.5.190025
language
English
LU publication?
yes
id
87a17564-bac6-4ad4-9bf4-740816d5dc73
date added to LUP
2020-03-18 16:37:04
date last changed
2021-02-17 04:32:42
@article{87a17564-bac6-4ad4-9bf4-740816d5dc73,
  abstract     = {<p>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.</p>},
  author       = {Clementson, Martin and Björkman, Anders and Thomsen, Niels O.B.},
  issn         = {2396-7544},
  language     = {eng},
  month        = {02},
  number       = {2},
  pages        = {96--103},
  publisher    = {British Editorial Society of Bone & Joint Surgery},
  series       = {EFORT open reviews},
  title        = {Acute scaphoid fractures : Guidelines for diagnosis and treatment},
  url          = {http://dx.doi.org/10.1302/2058-5241.5.190025},
  doi          = {10.1302/2058-5241.5.190025},
  volume       = {5},
  year         = {2020},
}