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Long-Term Outcomes After Distal Scaphoid Fractures : A 10-Year Follow-Up

Clementson, Martin LU ; Thomsen, Niels LU ; Besjakov, Jack LU ; Jørgsholm, Peter LU and Björkman, Anders LU (2017) In Journal of Hand Surgery
Abstract

Purpose: The aim of this study was to evaluate the functional, clinical, and radiological outcome 10 years after distal scaphoid fractures. Methods: From a prospective epidemiological study on posttraumatic radial-sided wrist pain, we evaluated 41 cases of distal scaphoid fractures. All cases had been treated nonsurgically in a thumb spica cast. Patients were examined using radiographs, magnetic resonance imaging and computed tomography at the time of injury and with computed tomography after a median of 10 years (range, 8-11 years). Fractures were classified according to a modified Prosser classification system. The primary outcome was assessment of self-reported function using Disabilities of the Arm, Shoulder, and Hand (DASH) and... (More)

Purpose: The aim of this study was to evaluate the functional, clinical, and radiological outcome 10 years after distal scaphoid fractures. Methods: From a prospective epidemiological study on posttraumatic radial-sided wrist pain, we evaluated 41 cases of distal scaphoid fractures. All cases had been treated nonsurgically in a thumb spica cast. Patients were examined using radiographs, magnetic resonance imaging and computed tomography at the time of injury and with computed tomography after a median of 10 years (range, 8-11 years). Fractures were classified according to a modified Prosser classification system. The primary outcome was assessment of self-reported function using Disabilities of the Arm, Shoulder, and Hand (DASH) and Patient-Reported Wrist Evaluation (PRWE). Secondary outcomes were clinical status (range of motion and grip and pinch strength) and to evaluate fracture healing and arthritis in the scaphotrapezium-trapezoid (STT) joint. Results: Functional impairment and pain scores at follow-up were low: median DASH score 2, median PRWE 0, and median visual analog scale (VAS) pain score 0. We found no impairment in range of motion or strength. We found 26 type I fractures, 12 type IIA, 1 type IIC, and 2 type IV. There was 1 asymptomatic nonunion in a type I fracture. Computed tomography revealed arthritis in the STT joint in 7 out of 41 wrists, none of which caused clinical symptoms. Conclusions: From an 8- to 11-year perspective, patients with distal scaphoid fractures report normal self-assessed hand function as well as good wrist motion and strength. The risk for development of posttraumatic STT arthritis was low. Type of study/level of evidence: Prognostic II.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Arthritis, Classification, CT, Outcome, Scaphoid fracture
in
Journal of Hand Surgery
publisher
Elsevier
external identifiers
  • scopus:85024473744
ISSN
0363-5023
DOI
10.1016/j.jhsa.2017.06.016
language
English
LU publication?
yes
id
8f2c0466-d4de-4cf0-b7c8-01600592649f
date added to LUP
2017-08-21 15:08:36
date last changed
2017-08-22 03:00:04
@article{8f2c0466-d4de-4cf0-b7c8-01600592649f,
  abstract     = {<p>Purpose: The aim of this study was to evaluate the functional, clinical, and radiological outcome 10 years after distal scaphoid fractures. Methods: From a prospective epidemiological study on posttraumatic radial-sided wrist pain, we evaluated 41 cases of distal scaphoid fractures. All cases had been treated nonsurgically in a thumb spica cast. Patients were examined using radiographs, magnetic resonance imaging and computed tomography at the time of injury and with computed tomography after a median of 10 years (range, 8-11 years). Fractures were classified according to a modified Prosser classification system. The primary outcome was assessment of self-reported function using Disabilities of the Arm, Shoulder, and Hand (DASH) and Patient-Reported Wrist Evaluation (PRWE). Secondary outcomes were clinical status (range of motion and grip and pinch strength) and to evaluate fracture healing and arthritis in the scaphotrapezium-trapezoid (STT) joint. Results: Functional impairment and pain scores at follow-up were low: median DASH score 2, median PRWE 0, and median visual analog scale (VAS) pain score 0. We found no impairment in range of motion or strength. We found 26 type I fractures, 12 type IIA, 1 type IIC, and 2 type IV. There was 1 asymptomatic nonunion in a type I fracture. Computed tomography revealed arthritis in the STT joint in 7 out of 41 wrists, none of which caused clinical symptoms. Conclusions: From an 8- to 11-year perspective, patients with distal scaphoid fractures report normal self-assessed hand function as well as good wrist motion and strength. The risk for development of posttraumatic STT arthritis was low. Type of study/level of evidence: Prognostic II.</p>},
  author       = {Clementson, Martin and Thomsen, Niels and Besjakov, Jack and Jørgsholm, Peter and Björkman, Anders},
  issn         = {0363-5023},
  keyword      = {Arthritis,Classification,CT,Outcome,Scaphoid fracture},
  language     = {eng},
  month        = {07},
  publisher    = {Elsevier},
  series       = {Journal of Hand Surgery},
  title        = {Long-Term Outcomes After Distal Scaphoid Fractures : A 10-Year Follow-Up},
  url          = {http://dx.doi.org/10.1016/j.jhsa.2017.06.016},
  year         = {2017},
}