Skip to main content
Erschienen in: Current Reviews in Musculoskeletal Medicine 1/2017

02.03.2017 | Hand and Wrist Sports Medicine (E Tolo and L Dwyer, section editors)

Scaphoid fractures in the athlete

verfasst von: Mark J. Winston, Andrew J. Weiland

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

Scaphoid fractures are a common wrist injury, especially in athletes. Clinicians should have a high index of suspicion for a scaphoid fracture in any patient complaining of radial-sided wrist pain after a fall on an outstretched hand. Advanced imaging, including CT and MRI scans, may be useful in diagnosis and classification of fracture patterns. Treatment varies based on the fracture location, stability of the fracture, and predictability of the fracture to heal. Treatment involves either non-operative management with a thumb spica cast or brace, or operative fixation with a headless compression screw, k-wires, or scaphoid-specific plates. Return to play is dependent on many variables, including sport, fracture union, and ability to play with cast.
Literatur
1.
Zurück zum Zitat Geissler WB, Slade JF. Fractures of the carpal bones. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, editors. Green’s Operative Hand Surgery, Sixth ed. Elsevier; 2011. Geissler WB, Slade JF. Fractures of the carpal bones. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, editors. Green’s Operative Hand Surgery, Sixth ed. Elsevier; 2011.
2.
Zurück zum Zitat Wolf JM, Dawson L, Mountcastle SB, et al. The incidence of scaphoid fracture in a military population. Injury. 2009;40:1316–9.CrossRefPubMed Wolf JM, Dawson L, Mountcastle SB, et al. The incidence of scaphoid fracture in a military population. Injury. 2009;40:1316–9.CrossRefPubMed
3.
Zurück zum Zitat Rettig AC, Ryan RO, Stone JS. Epidemiology of hand injuries in sports. In: Strickland JW, Rettig AC, editors. Hand injuries in athletes. Philadelphia: WB Saunders; 1992. p. 37–48. Rettig AC, Ryan RO, Stone JS. Epidemiology of hand injuries in sports. In: Strickland JW, Rettig AC, editors. Hand injuries in athletes. Philadelphia: WB Saunders; 1992. p. 37–48.
4.
Zurück zum Zitat Weber ER, Chao EY. An experimental approach to the mechanism of scaphoid waist fracture. J Hand Surg [Am]. 1978;3:142–8.CrossRef Weber ER, Chao EY. An experimental approach to the mechanism of scaphoid waist fracture. J Hand Surg [Am]. 1978;3:142–8.CrossRef
5.
Zurück zum Zitat Horii E, Nakamura R, Watanabe K, et al. Scaphoid fracture as a puncher’s fracture. J Orthop Trauma. 1994;8:107–10.CrossRefPubMed Horii E, Nakamura R, Watanabe K, et al. Scaphoid fracture as a puncher’s fracture. J Orthop Trauma. 1994;8:107–10.CrossRefPubMed
6.
Zurück zum Zitat • Patel NK, Davies N, Mriza Z, Watson M. Cost and clinical effectiveness of MRI in occult scaphoid fractures: a randomized controlled trial. Emerg Med J. 2013;30(3):202–7. Looked at patients with suspected scaphoid injuries. Half of patients were treated with thump spica casting and repeat X-rays 2 weeks later. The other half of the study population received immediate MRI. If MRI was negative, the patient was discharged with no follow-up. Early MRI group had cost savings compared to control group given avoidance of cast fees and fewer clinic appointments. They also had earlier return to work and sporting activities. • Patel NK, Davies N, Mriza Z, Watson M. Cost and clinical effectiveness of MRI in occult scaphoid fractures: a randomized controlled trial. Emerg Med J. 2013;30(3):202–7. Looked at patients with suspected scaphoid injuries. Half of patients were treated with thump spica casting and repeat X-rays 2 weeks later. The other half of the study population received immediate MRI. If MRI was negative, the patient was discharged with no follow-up. Early MRI group had cost savings compared to control group given avoidance of cast fees and fewer clinic appointments. They also had earlier return to work and sporting activities.
7.
Zurück zum Zitat Cooney III WP, Dobyns JH, Linscheid RL. Nonunion of the scaphoid: analysis of the results from bone grafting. J Hand Surg [Am]. 1980;5(4):343–54.CrossRef Cooney III WP, Dobyns JH, Linscheid RL. Nonunion of the scaphoid: analysis of the results from bone grafting. J Hand Surg [Am]. 1980;5(4):343–54.CrossRef
8.
Zurück zum Zitat Linscheid RL, Dobyns JH, Beabout JW, et al. Traumatic instability of the wrist: diagnosis, classification, and pathomechanics. J Bone Joint Surg Am. 2002;84-A(1):142.CrossRefPubMed Linscheid RL, Dobyns JH, Beabout JW, et al. Traumatic instability of the wrist: diagnosis, classification, and pathomechanics. J Bone Joint Surg Am. 2002;84-A(1):142.CrossRefPubMed
9.
Zurück zum Zitat Russe O. Fracture of the carpal navicular. Diagnosis, non-operative treatment, and operative treatment. J Bone Joint Surg Am. 1960;42-A:759–68.CrossRefPubMed Russe O. Fracture of the carpal navicular. Diagnosis, non-operative treatment, and operative treatment. J Bone Joint Surg Am. 1960;42-A:759–68.CrossRefPubMed
10.
Zurück zum Zitat Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney III WP, Linscheid RL. Scaphoid malunion. J Hand Surg [Am]. 1989;14:679–87.CrossRef Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney III WP, Linscheid RL. Scaphoid malunion. J Hand Surg [Am]. 1989;14:679–87.CrossRef
11.
Zurück zum Zitat Adams BD, Blair WF, Reagan DS, et al. Technical factors related to Herbert screw fixation. J Hand Surg (Am). 1988;13:893–9.CrossRef Adams BD, Blair WF, Reagan DS, et al. Technical factors related to Herbert screw fixation. J Hand Surg (Am). 1988;13:893–9.CrossRef
12.
Zurück zum Zitat Amadio PC, Berquist TH, Smith DK, et al. Scaphoid malunion. J Hand Surg Am. 1989;14:679–87.CrossRefPubMed Amadio PC, Berquist TH, Smith DK, et al. Scaphoid malunion. J Hand Surg Am. 1989;14:679–87.CrossRefPubMed
13.
Zurück zum Zitat Berger RA. The anatomy of the scaphoid. Hand Clin. 2001;17:525–32.PubMed Berger RA. The anatomy of the scaphoid. Hand Clin. 2001;17:525–32.PubMed
14.
Zurück zum Zitat Gelberman RH, Menon J. The vascularity of the scaphoid bone. J Hand Surg [Am]. 1980;5:508–13.CrossRef Gelberman RH, Menon J. The vascularity of the scaphoid bone. J Hand Surg [Am]. 1980;5:508–13.CrossRef
15.
Zurück zum Zitat Gelberman RH, Wolock BS, Siegel DB. Fractures and non-unions of the carpal scaphoid. J Bone Joint Surg Am. 1989;71:1560–5.CrossRefPubMed Gelberman RH, Wolock BS, Siegel DB. Fractures and non-unions of the carpal scaphoid. J Bone Joint Surg Am. 1989;71:1560–5.CrossRefPubMed
16.
Zurück zum Zitat Herbert TH. The fracture scaphoid. St Louis: Quality Medical Publishing; 1990. Herbert TH. The fracture scaphoid. St Louis: Quality Medical Publishing; 1990.
17.
Zurück zum Zitat • Everding NG, Evans PJ. Scaphoid Fractures in the Athlete: Acute and Chronic. The Athlete’s Hand and Wrist: A Master Skills Publication. Chapter 13. Chicago: American Society for Surgery of the Hand; 2014. Comprehensive text for evaluation and treatment of all common injuries seen in athletes. • Everding NG, Evans PJ. Scaphoid Fractures in the Athlete: Acute and Chronic. The Athlete’s Hand and Wrist: A Master Skills Publication. Chapter 13. Chicago: American Society for Surgery of the Hand; 2014. Comprehensive text for evaluation and treatment of all common injuries seen in athletes.
18.
Zurück zum Zitat Haisman JM, Rohde RS, Weiland AJ. Acute fractures of the scaphoid. An instructional course lecture. J Bone Joint Surg. 2006;88-A(12). Haisman JM, Rohde RS, Weiland AJ. Acute fractures of the scaphoid. An instructional course lecture. J Bone Joint Surg. 2006;88-A(12).
19.
Zurück zum Zitat Dias JJ, Taylor M, Thompson J, et al. Radiographic signs of union of scaphoid fractures. An analysis of inter-observer agreement and reproducibility. J Bone Joint Surg Br. 1988;70:299–301.CrossRefPubMed Dias JJ, Taylor M, Thompson J, et al. Radiographic signs of union of scaphoid fractures. An analysis of inter-observer agreement and reproducibility. J Bone Joint Surg Br. 1988;70:299–301.CrossRefPubMed
20.
Zurück zum Zitat Richards RS, Roth JH. Common wrist injuries. In: Chan KM, editor. Sports Injuries of the Hand and Upper Extremity. New York: Churchill Livingstone; 1995. p. 214–5. Richards RS, Roth JH. Common wrist injuries. In: Chan KM, editor. Sports Injuries of the Hand and Upper Extremity. New York: Churchill Livingstone; 1995. p. 214–5.
21.
Zurück zum Zitat Dias JJ, Dhukaram V, Abhinav A, et al. Clinical and radiological outcome of cast immobilization versus surgical treatment of acute scaphoid fractures at a mean follow up of 93 months. J Bone Joint Surg (Br). 2008;90(7):899–905.CrossRef Dias JJ, Dhukaram V, Abhinav A, et al. Clinical and radiological outcome of cast immobilization versus surgical treatment of acute scaphoid fractures at a mean follow up of 93 months. J Bone Joint Surg (Br). 2008;90(7):899–905.CrossRef
22.
Zurück zum Zitat Dias JJ, Brenkel IJ, Finlay DB. Patterns of union in fractures of the waist of the scaphoid. J Bone Joint Surg (Br). 1989;71(2):307–10. Dias JJ, Brenkel IJ, Finlay DB. Patterns of union in fractures of the waist of the scaphoid. J Bone Joint Surg (Br). 1989;71(2):307–10.
23.
Zurück zum Zitat Ford DJ, Kjoury G, el-Hadidi S, et al. The Herbert screw for fractures of the scaphoid. A review of results and technical difficulties. J Bone Joint Surg (Br). 1987;69(1):124–7. Ford DJ, Kjoury G, el-Hadidi S, et al. The Herbert screw for fractures of the scaphoid. A review of results and technical difficulties. J Bone Joint Surg (Br). 1987;69(1):124–7.
24.
Zurück zum Zitat Doornberg JN, Buijze GA, Ham SJ, et al. Nonoperative treatment for acute scaphoid fractures: a systematic review and meta-analysis of randomized controlled trials. J Trauma. 2011;71(4):1073–81.CrossRefPubMed Doornberg JN, Buijze GA, Ham SJ, et al. Nonoperative treatment for acute scaphoid fractures: a systematic review and meta-analysis of randomized controlled trials. J Trauma. 2011;71(4):1073–81.CrossRefPubMed
25.
Zurück zum Zitat • Bond CD, Shin AY, McBride MR, et al. Percutaneous screw fixation or cast immobilization for nondisplaced scaphoid fractures. J Bone Joint Surg Am. 2001;83-A(4):483–8. Study compared scaphoid fractures treated nonoperatively and operatively in military recruits, which closely resembles an athlete with return to play.CrossRefPubMed • Bond CD, Shin AY, McBride MR, et al. Percutaneous screw fixation or cast immobilization for nondisplaced scaphoid fractures. J Bone Joint Surg Am. 2001;83-A(4):483–8. Study compared scaphoid fractures treated nonoperatively and operatively in military recruits, which closely resembles an athlete with return to play.CrossRefPubMed
26.
Zurück zum Zitat Cooney WP, Dobyns JG, Linscheid RL. Fractures of the scaphoid: a rational approach to management. Clin Orthop. 1980;149:90–7. Cooney WP, Dobyns JG, Linscheid RL. Fractures of the scaphoid: a rational approach to management. Clin Orthop. 1980;149:90–7.
27.
Zurück zum Zitat McCallister MV, Knight J, Kaliappan R, Trumble TE. Central placement of the screw in simulated fractures of the scaphoid waist: a biomechanical study. J Bone Joint Surg Am. 2003;85(1):72–7.CrossRefPubMed McCallister MV, Knight J, Kaliappan R, Trumble TE. Central placement of the screw in simulated fractures of the scaphoid waist: a biomechanical study. J Bone Joint Surg Am. 2003;85(1):72–7.CrossRefPubMed
28.
Zurück zum Zitat Rettig AC, Weidenbener DJ, Gloyeske R. Alternative management of midthird scaphoid fractures in the athlete. Am J Sport Med. 1994;22(5):711–4.CrossRef Rettig AC, Weidenbener DJ, Gloyeske R. Alternative management of midthird scaphoid fractures in the athlete. Am J Sport Med. 1994;22(5):711–4.CrossRef
29.
Zurück zum Zitat Rettig AC, Kollias SC. Internal fixation of acute stable scaphoid fractures in the athlete. Am J Sport Med. 1996;24(2):182–6.CrossRef Rettig AC, Kollias SC. Internal fixation of acute stable scaphoid fractures in the athlete. Am J Sport Med. 1996;24(2):182–6.CrossRef
30.
Zurück zum Zitat Slade III JF, Gillon T. Retrospective review of 234 scaphoid fractures and nonunions treated with arthroscopy for union and complications. Scand J Surg. 2008;97(4):280–9.CrossRefPubMed Slade III JF, Gillon T. Retrospective review of 234 scaphoid fractures and nonunions treated with arthroscopy for union and complications. Scand J Surg. 2008;97(4):280–9.CrossRefPubMed
31.
Zurück zum Zitat Belsky MR, Leibman MI, Ruschelsman DE. Scaphoid fracture in the elite athlete. Hand Clin. 2012;28(3):269–78.CrossRefPubMed Belsky MR, Leibman MI, Ruschelsman DE. Scaphoid fracture in the elite athlete. Hand Clin. 2012;28(3):269–78.CrossRefPubMed
32.
Zurück zum Zitat Riester JN, Baker BE, Mosher JF, Lowe D. A review of scaphoid fracture healing in competitive athletes. Am J Sports Med. 1985;13(3):159–61.CrossRefPubMed Riester JN, Baker BE, Mosher JF, Lowe D. A review of scaphoid fracture healing in competitive athletes. Am J Sports Med. 1985;13(3):159–61.CrossRefPubMed
33.
Zurück zum Zitat • Dy CJ, Khmelnitskaya E, Hearns KA, Carlson MG. Opinions regarding the management of hand and wrist injuries in elite athletes. Orthopedics. 2013;36(6):815–9. Includes surveys of surgeons taking care of professional athletes in different sports and preferences for return to play.CrossRefPubMed • Dy CJ, Khmelnitskaya E, Hearns KA, Carlson MG. Opinions regarding the management of hand and wrist injuries in elite athletes. Orthopedics. 2013;36(6):815–9. Includes surveys of surgeons taking care of professional athletes in different sports and preferences for return to play.CrossRefPubMed
Metadaten
Titel
Scaphoid fractures in the athlete
verfasst von
Mark J. Winston
Andrew J. Weiland
Publikationsdatum
02.03.2017
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 1/2017
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-017-9382-y

Weitere Artikel der Ausgabe 1/2017

Current Reviews in Musculoskeletal Medicine 1/2017 Zur Ausgabe

Foot and Ankle Sports Medicine (M Drakos, section editor)

Current trends in the diagnosis and management of syndesmotic injury

Hand and Wrist Sports Medicine (E Tolo and L Dwyer, section editors)

Scapholunate and perilunate injuries in the athlete

Foot and Ankle Sports Medicine (M Drakos, section editor)

Lisfranc injuries

Foot and Ankle Sports Medicine (M Drakos, section editor)

Injuries to the great toe

Foot and Ankle Sports Medicine (M Drakos, section editor)

Tarsal navicular stress fractures

Social Media and Orthopedics (P Sculco, section editor)

Social media for patients: benefits and drawbacks

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.