Pediatric Scaphoid Fracture

Etiology: Trauma
Imaging Radiograph: Obliterated fat plane adjacent to the scaphoid can be an important clue
Note: Easy to miss on radiographs even when using dedicated scaphoid view and therefore radiographs cannot exclude acute scaphoid fracture so if snuff box tenderness persists get followup radiographs 2 weeks after injury to look for signs of healing
Imaging CT: Can confirm or exclude acute fracture
Imaging MRI: Can confirm or exclude acute fracture
DDX:
Complications:
— Nonunion – usually of scaphoid waist fracture
— Avascular necrosis of proximal pole of scaphoid
Treatment:
Clinical: Scaphoid is most common carpal bone fracture

Radiology Cases of Scaphoid Fracture

Radiograph of scaphoid fracture — AP radiograph of the wrist shows a thin lucent line through the center of the scaphoid bone. On physical exam the patient had point tenderness over this area.

Radiograph of scaphoid fracture — AP radiograph of the wrist (left) shows a double density over the scaphoid bone. Scaphoid view (right) shows a lucency through the waist of the scaphoid bone with displacement of the fracture fragments.

Radiograph of scaphoid fracture — AP radiograph of the wrist shows a lucent line with some adjacent sclerosis through the waist of the scaphoid bone.