Clinical Scaphoid Fractures in Children: A Prospective Radiological Study

Description

This presentation, delivered by Sasha Carsen, focuses on a prospective radiological study regarding clinical scaphoid fractures in children, conducted by a research group from Cheo and the University of Ottawa. It begins with an overview of the challenges associated with diagnosing and treating scaphoid fractures in the pediatric population, especially due to incomplete ossification and the often occult nature of these injuries. The newly defined term "clinical scaphoid" pertains to injuries that exhibit clinical signs of a scaphoid fracture, despite negative initial x-rays, thus complicating diagnosis and treatment due to the lack of established protocols and limited evidence, particularly in children.



The study aims to determine the actual incidence of scaphoid fractures among children presenting with clinical suspicion of a fracture, and to assess the potential for a larger clinical trial in future investigations. Methodology involved enrolling patients from fracture clinics and examining those under 18 years old with clinical signs of an injury but negative x-rays, ruling out others with confounding factors.



Results indicated that of 25 enrolled patients, a significant 36% were found to have true scaphoid fractures based on advanced imaging scans (CT or MRI), revealing a higher incidence than previously reported. The study also highlighted the importance of advanced imaging, noting discrepancies in fracture diagnosis between CT and MRI results. Finally, the findings underscore the necessity of further research to establish better diagnostic and treatment guidelines in pediatric cases of clinical scaphoid injuries.

DOI: 10.1302/3114-220825

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