Scaphoid Fracture Associated with Distal Radius Fracture in Children: a Case Report

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Chinese Journal of Traumatology 2009; 12(3):187-188 . 187 .

Scaphoid fracture associated with distal radius fracture in children: a case report

Hamdi Med Faouzi *

he forearm distal bone fracture is the most common fracture in children. Scaphoid frac- Tture is rare because the scaphoid is largely cartilaginous in children. Some cases associating both distal radius and scaphoid fractures were reported in the literature. Scaphoid fracture often occurs without displacement and can be easily overlooked. We reported a case of children wrist injury combining scaphoid fracture with ipsilateral distal fracture.

CASE REPORT

A 14-year-old boy was seen in the emergency de- Fig. 1. Initial anteroposterior (A) and lateral (B) radiographics of partment of our hospital after sustaining a sport-related the right wrist show a Salter-Harris type II distal radius fracture associated with ipsilateral scaphoid fracture. fall on his outstretched right hand. The patient com- plained of pain and deformity of the wrist. Clinical ex- amination revealed swelling on the dorsum of wrist. The neurovascular status was normal.

The roentgenograms of the wrist revealed displaced Salter-Harris type II distal radius fracture associated with an ipsilateral undisplated transverse midscaphoid fracture (Fig.1). Immediate reduction of radius fracture was performed under general anaesthesia by gentle closed manipulation to avoid the displacement of scaphoid fracture. The wrist was immobilized in a long- arm thumb spica cast for 11 weeks. In seven months follow-up, his wrist had a full range of motion without Fig. 2. Anteroposterior (A) and lateral (B) radiographics of the right wrist at the seven months follow-up reveal a union of scaphoid symptoms, and the fracture bone was strengthened in and distal radius fractures. good position (Fig. 2). DISCUSSION

Although distal radius fractures have been consid- ered as a common fracture in children, scaphoid fractures are rare in the same age1-3 and constitute about 0.4% of all pediatric fractures.1, 4, 5 The combination of DOI: 10.3760/cma.j.issn.1008-1275.2009.03.014 distal radius and ipsilateral scaphoid fractures in chil- Department of Trauma and Orthopaedic Surgery, Hos- dren is remarkably rare and only a few cases have been pital of Fattouma Bourguiba University, Monastir 5000, Tu- 5-10 11 nisia (Faouzi HM) reported. Compson reported three cases of trans- *Corresponding author: Tel: 216-99831236, Fax: 216- carpal injuries associated with an ipsilateral distal ra- 73460678, E-mail: [email protected] dius fracture in children, including two cases of simul- . 188 . Chinese Journal of Traumatology 2009; 12(3):187-188 taneous fracture of the scaphoid and the capitate and In conclusion, if a child presents a distal radius one case of scaphoid and triquetrum fracture. fracture, associated carpal injury should be recognized especially in great external force. The diagnosis of si- In children aged from 5-15 years, the scaphoid is a multaneous displaced distal radius and scaphoid frac- cartilaginous mass surrounding ossific nucleus.9 The tures leads to adequate treatment and a satisfactory thick layer of cartilage surrounding the ossification center clinical result. provides a cushion-effect against fractures, 7,12 so scaphoid fractures in children require a great causal REFERENCES force.8 The scaphoid fracture is the most common carpal fracture in children with a peak incidence between 1. Christodoulou AG, Colton CL. Scaphoid fractures in the ages of 12-15 years.2 Ligamentous and cartilagi- children. 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