Spontaneous Healing of a Pediatric Scaphoid Proximal Pole Fracture NonunionFunding None.
19 December 2016
04 April 2017
09 May 2017 (eFirst)
Background Scaphoid fractures in the pediatric population are rare. The majority of nondisplaced fractures tend to unite; however, there is an increased risk of nonunion in proximal pole fractures. Limited evidence exists in their outcomes, owing to the scarcity of the fracture pattern.
Case Description A 13-year-old boy who presented late after developing a traumatic proximal pole scaphoid fracture developed nonunion. He was treated conservatively owing to it being asymptomatic and developed union at 18 months.
Literature Review No previous case of proximal pole pediatric scaphoid fractures with established nonunion that has developed union with conservative management has been described.
Clinical Relevance The authors highlight a unique case of an established proximal pole scaphoid nonunion in a child progressing to union with nonoperative intervention. Owing to its rarity and difficulty in obtaining research, we recommend consideration of nonoperative management of asymptomatic nondisplaced proximal pole fractures in children.
- 1 Christodoulou AG, Colton CL. Scaphoid fractures in children. J Pediatr Orthop 1986; 6 (01) 37-39
- 2 Gholson JJ, Bae DS, Zurakowski D, Waters PM. Scaphoid fractures in children and adolescents: contemporary injury patterns and factors influencing time to union. J Bone Joint Surg Am 2011; 93 (13) 1210-1219
- 3 Maxted MJ, Owen R. Two cases of non-union of carpal scaphoid fractures in children. Injury 1982; 13 (05) 441-443
- 4 Vahvanen V, Westerlund M. Fracture of the carpal scaphoid in children. A clinical and roentgenological study of 108 cases. Acta Orthop Scand 1980; 51 (06) 909-913
- 5 Clarke J, Ramjug S, Barnes S. Established scaphoid nonunion progressing to spontaneous union in a child. Inj Extra 2006; 37 (04) 170-171
- 6 Divecha HM, Clarke JV, Barnes SJ. Established non-union of an operatively managed trans-scaphoid perilunate fracture dislocation progressing to spontaneous union. J Orthop Traumatol 2011; 12 (03) 159-162
- 7 Weber DM, Fricker R, Ramseier LE. Conservative treatment of scaphoid nonunion in children and adolescents. J Bone Joint Surg Br 2009; 91 (09) 1213-1216
- 8 Manak P, Drac P, Paucek B. Spontaneous consolidation of scaphoid nonunion in a child. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2008; 152 (02) 271-273
- 9 Park MJ, Lee AT, Yao J. An unusual case of spontaneous healing of a proximal pole scaphoid non-union. Hand (NY) 2011; 6 (03) 313-316
- 10 Beaty J, Kasser J. Rockwood & Wilkins': Fractures in Children. Baltimore: Lippincott Williams & Wilkins;; 2006