BACKGROUND Many patients with suspected scaphoid fractures but negative radiographs are immobilized for ≥ 2 weeks and are eventually found to have no fracture. Bone scans are reportedly 99% sensitive for these injuries if done ≥ 72 hours postinjury. OBJECTIVE The purpose of this study was to determine if early bone scans would allow for shorter cast immobilization periods in patients with sus...

BACKGROUND: The scaphoid is the most prominent of the carpal bones in the first row and the most frequently fractured of all the carpal bones. Bilateral simultaneous scaphoid fractures are uncommon. OBJECTIVE: To report bilateral simultaneous fractures of the carpal scaphoid bones and their successful treatment with bilateral thumb spacia casts METHODS: A 28-year-old medical practitioner presen...

BACKGROUND AND PURPOSE Fractures of the scaphoid are often not detected on initial plain radiographs. Conventional management of clinically suspected scaphoid fractures is cast immobilization for 2 weeks and then reassessment. Early MRI is a diagnostic alternative. We compared the cost and usefulness of the early MRI diagnostic strategy with that of conventional management. PATIENTS AND METHO...

Scaphoid fracture with ipsilateral metacarpal fracture dislocation is very rare. A unique case of this injury is reported. It is important to be aware of this fracture pattern so that appropriate evaluation and treatment can be instituted. Thorough clinical and radiographic examination at the initial presentation of the patient is the key to identify uncommon combination of injuries.

OBJECTIVE We developed and implemented clinical practice guideline (CPG) using computerized tomography (CT) as the initial imaging method in the emergency department management of scaphoid fractures. We hypothesized that this CPG would decrease unnecessary immobilization and lead to earlier return to work. METHODS This observational study evaluated implementation of our CPG, which incorporate...

We report the case of a 21-year-old man who injured his right hand in a fall from his motorbike, causing a trans-scaphoid perilunate fracture-dislocation associated with vertical fracture of the pyramid (A and B). On day 2, patient underwent a bloody reduction (C) of disorganized carpal bones with osteosynthesis of scaphoid and pyramid (D). Peri-lunate fracture-dislocation is a rare injury cons...

Scapho-capitate fractures, also known as Fenton's Syndrome, occur very rarely. We report a case of a variant capitate fracture with a 180 degree rotation of the proximal fragment and no identifiable scaphoid fracture. Prompt identification of this fracture is necessary to minimize complications such as avascular necrosis.

The distal row, which is more stable and moves as a unit, consists of the trapezium, the trapezoid, the capitate, and the hamate. The distal row forms a rigid, supportive transverse arch upon which the five metacarpals of the hand are supported. The trapezium articulates with the first metacarpal, the trapezoid with the second, and the capitate with the third one. The capitate and trapezoid are...

Figure 1. Preoperative posteroanterior radiographs showing progressive fragmentation and collapse of the lunate, as well as subsequent pathologic fracture of the scaphoid.

Scaphoid stress fractures are rare injuries that have been described in young, high-level athletes who exhibit repetitive loading with the wrist in extension. We present a case of an occult scaphoid stress fracture in a 22-year-old female Division I collegiate shot-putter. She was successfully treated with immobilization in a thumb spica splint for 6 weeks. Loaded wrist extension activities can...