A New Mechanism of Injury for Scaphoid Fractures: ‘Test Your Strength’ Punch-Bag Machines

Sutton, Paul; Clifford, O; Davis, T. R. C.

doi:10.1177/1753193409352713

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…The increasing number of punching-or assault-related injuries are becoming more prominent in the literature. 15,16 Our data are comparable to other literature with the mean age of true scaphoid fractures ranging from 25 years to 35 years and a type B unimodal young male distribution. 2,3,17,18 A male predominance was observed, but not as great as some studies have suggested.…”

Section: Discussionsupporting

confidence: 93%

Scaphoid fracture epidemiology

Duckworth

Jenkins

Aitken

et al. 2012

Journal of Trauma and Acute Care Surgery

114

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BACKGROUND:The current available literature related to scaphoid fracture epidemiology is inconsistent. The aim of this study was to describe the epidemiology of true scaphoid fractures in a defined adult population. METHODS:Using a prospective database, we identified all patients who sustained a radiographically confirmed acute fracture of the scaphoid over a 1-year period. Age, gender, mechanism of injury, the Herbert fracture classification, and associated injuries were recorded and analyzed. RESULTS:There were 151 scaphoid fractures diagnosed giving an annual incidence of 29 per 100,000 (95% confidence interval, 25-34). The median age of males was significantly younger when compared with females (p ϭ 0.002), with a male (n ϭ 105) predominance seen (p Ͻ 0.001). Low-energy falls from a standing height were most common (40.4%), but with males being significantly more likely to sustain their fracture after a high-energy injury (p Ͻ 0.001). The most common fracture was Herbert classification B2 (n ϭ 55, 36.4%), with unstable fractures more common in younger patients (p ϭ 0.025) following a high-energy injury (p ϭ 0.042). CONCLUSIONS: We have reported the epidemiology of true scaphoid fractures, with young males at risk of sustaining a fracture. Knowledge of the true incidence of scaphoid fractures and an understanding of the demographic risk factors are essential when assessing the suspected scaphoid fracture, particularly when considering further imaging modalities. (J Trauma. 2012;72: E41-E45. CopyrightA cute scaphoid fractures account for only 2% to 3% of all fractures and ϳ10% of all hand fractures. 1-3 The literature related to the epidemiology of scaphoid fractures is inconsistent with a hundred-fold difference quoted with regards the incidence. 2-8 This is potentially due to the retrospective nature of most analyses, the difficulty associated with defining the population assessed, and the limitation of many databases in distinguishing between suspected and confirmed fractures. 2-8 A clear understanding of the incidence, and the demographic risk factors, associated with a true scaphoid fracture is essential when considering the assessment of the suspected fracture.The aim of this study was to report the epidemiology and demographic risk factors associated with a true acute scaphoid fracture in a large defined population. PATIENTS AND METHODSOur trauma unit serves a captive adult (Ն13 years of age) population of ϳ514,479, with 244,112 males (47.4%) and 270,367 females (52.6%). All inpatient and outpatient fractures that presented acutely to our unit over a 1-year period from July 2007 to June 2008 were recorded prospectively. Patients who presented to our unit but who lived out with our local catchment area were excluded. The regional pediatric hospital manages patients aged less than 13 years and therefore these fractures were not included.A search of our prospective trauma database identified a subgroup of patients who had suffered an acute fracture of the scaphoid. Demographic data were collected for each p...

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Section: Discussionsupporting

confidence: 93%

Scaphoid fracture epidemiology

Duckworth

Jenkins

Aitken

et al. 2012

Journal of Trauma and Acute Care Surgery

114

View full text Add to dashboard Cite

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“…A previous report indicated that scaphoid and trapezoid fractures accounted for 68.2% and 0.4% of all carpal bone fractures, respectively [4]. With respect to the mechanism of injury, there are some reports on scaphoid fractures due to punching [5, 6]. However, the simultaneous occurrence of trapezoid and scaphoid fractures in sports has never been reported.…”

Section: Introductionmentioning

confidence: 99%

Trapezoid Fracture Associated with Scaphoid Fracture in a Football Goalkeeper

Yamamoto

Matsushita

Ito

et al. 2019

Case Reports in Orthopedics

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Introduction. Trapezoid fractures are uncommon in sports. We presented a rare case of a trapezoid fracture associated with a scaphoid fracture caused by punching a ball in a football goalkeeper. Case Presentation. A 19-year-old male who played as a football goalkeeper visited our hospital with complaints of sustained pain from the right wrist to the hand after punching a ball. Scaphoid fracture was diagnosed on plain radiographs, whereas trapezoid fracture was overlooked. Computed tomography revealed a displaced trapezoid fracture associated with a scaphoid fracture. Both fractures were successfully treated by open reduction and internal fixation using cannulated screws. Almost complete bone union was achieved at 5 months after surgery. The patient returned to play as a football goalkeeper. Conclusion. The simultaneous occurrence of trapezoid and scaphoid fractures has never been reported. Trapezoid fractures are rare and can be overlooked on plain radiographs, as what happened in the present case, because the trapezoid is small and overlaps with other carpal bones on plain radiographs. If there is sustained pain in the wrist and hand after punching, combined trapezoid and scaphoid fractures should be considered as the possible injury.

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“…Football, basketball, cycling, and skateboarding have all been associated with an increased risk of fracture, although this varies depending on study origin 15,16 . Scaphoid fractures also result from recreational punching or assault 18,19 . Two studies have reported that male sex and sports injuries are risk factors that are associated with true fractures 8,20 .…”

Section: Epidemiologymentioning

confidence: 99%

Diagnosis of Suspected Scaphoid Fractures

et al. 2021

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Suspected scaphoid fractures are a diagnostic and therapeutic challenge despite the advances in knowledge regarding these injuries and imaging techniques. The risks and restrictions of routine immobilization as well as the restriction of activities in a young and active population must be weighed against the risks of nonunion that are associated with a missed fracture.The prevalence of true fractures among suspected fractures is low. This greatly reduces the statistical probability that a positive diagnostic test will correspond with a true fracture, reducing the positive predictive value of an investigation.There is no consensus reference standard for a true fracture; therefore, alternative statistical methods for calculating sensitivity, specificity, and positive and negative predictive values are required.Clinical prediction rules that incorporate a set of demographic and clinical factors may allow stratification of secondary imaging, which, in turn, could increase the pretest probability of a scaphoid fracture and improve the diagnostic performance of the sophisticated radiographic investigations that are available.Machine-learning-derived probability calculators may augment risk stratification and can improve through retraining, although these theoretical benefits need further prospective evaluation.Convolutional neural networks (CNNs) are a form of artificial intelligence that have demonstrated great promise in the recognition of scaphoid fractures on radiographs. However, in the more challenging diagnostic scenario of a suspected or so-called “clinical” scaphoid fracture, CNNs have not yet proven superior to a diagnosis that has been made by an experienced surgeon.

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A New Mechanism of Injury for Scaphoid Fractures: ‘Test Your Strength’ Punch-Bag Machines

Cited by 8 publications

References 7 publications

Scaphoid fracture epidemiology

Scaphoid fracture epidemiology

Trapezoid Fracture Associated with Scaphoid Fracture in a Football Goalkeeper

Diagnosis of Suspected Scaphoid Fractures

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