Long-Term Outcomes After Distal Scaphoid Fractures : A 10-Year Follow-Up
(2017) In The Journal of Hand Surgery 42(11). p.1-927- 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.
(Less)
- author
- Clementson, Martin LU ; Thomsen, Niels LU ; Besjakov, Jack LU ; Jørgsholm, Peter LU and Björkman, Anders LU
- organization
- publishing date
- 2017-07-18
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Arthritis, Classification, CT, Outcome, Scaphoid fracture
- in
- The Journal of Hand Surgery
- volume
- 42
- issue
- 11
- pages
- 1 - 927
- publisher
- Elsevier
- external identifiers
-
- pmid:28733100
- wos:000415601300012
- 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
- 2024-05-12 19:14:21
@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}},
keywords = {{Arthritis; Classification; CT; Outcome; Scaphoid fracture}},
language = {{eng}},
month = {{07}},
number = {{11}},
pages = {{1--927}},
publisher = {{Elsevier}},
series = {{The 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}},
doi = {{10.1016/j.jhsa.2017.06.016}},
volume = {{42}},
year = {{2017}},
}