Bilateral combined fractures of the scaphoid and distal radius: a case report

Abstract

Introduction: A combination of bilateral scaphoid and distal radius fractures is extremely rare. It may occur as a result of high-energy trauma and can be neglected. The current paper described a case study of this rarely combined fracture. Case Report: A 22-year-old female was admitted to the emergency department following a fall while exercising which resulted in severe pain in both wrists without any neurovascular deficit. X-ray imaging showed bilateral combined fractures of the scaphoid and distal radius. To fix the fractures, the patient underwent closed reduction and internal fixation with Kirschner wires along with immobilization for 3 months. The radius and scaphoid fractures were united within approximately 6 and 10 weeks, respectively. Conclusion: Combined bilateral scaphoid and distal radius fractures are extremely rare resulting from high-energy trauma. The associated fractures require a precise diagnosis and appropriate therapeutic management. Keywords: distal radius, scaphoid, fracture, bilateral, reduction

Bilateral Scaphoid Fractures: A Systematic Literature Review

“…Meraghni et al [21] reported a single case (6.25%) involving bilateral scaphoid fractures classified as A2 according to Herbert's classification, whereas Kay et al [12] documented a single case (6.25%) featuring bilateral fractures classified as A1. Fractures exhibiting discordance bilaterally based on Herbert's classification were documented in 25% of cases (n = 4) as follows:…”

“…In 75% of the cases (n = 12), the injury mechanism involved high-energy trauma. Specifically, 37.5% of the cases (n = 6) resulted from falls from a height [11][12][13][14]20,23], 6.25% (n = 1) were related to a traffic accident [24], 18.75% (n = 3) were associated with falls onto both outstretched hands [15,16,19], and 12.5% (n = 2) were attributed to sports-related trauma (Table 2) [1,21]. Four patients (n = 4; 25%) did not disclose specific traumatic events; instead, they reported multiple minor traumas occurring repeatedly over time, categorizing these fractures as stress fractures [17,18,22,25].…”

“…In 68.75% of cases (n = 11), associated wrist injuries were identified; of these, 36.36% (n = 4) presented with bilateral distal radius fractures [11,14,21,23], 45.45% (n = 5) had bilateral dislocations of carpal bones [13,16,19,20,23], and 18.18% (n = 2) had bilateral non-scaphoid carpal bone fractures [20,24]. In 6.25% of cases (n = 1), a bilateral proximal radius fracture was described [12], while, in 12.5% of cases (n = 2), injuries to the vertebral column were reported [11,14].…”

“…According to Herbert's classification for scaphoid fractures, 31.25% of cases (n = 5) exhibited bilateral B2-type fractures [11,14,17,22,25], 29.41% of cases (n = 5) bilateral B4-type fractures [13,16,19,20,23], 6.25% of cases (n = 1) bilateral A2-type fractures [21], and 6.25% (n = 1) bilateral A1-type fractures [12].…”

“…The remaining 68.75% (n = 11) underwent surgery. Among these, 72.73% (n = 8) were treated with headless compression screws [13,14,16,[18][19][20]23,24], 9.09% (n = 1) were treated with headless compression screws and bone grafting [1], 9.09% (n = 1) were treated with percutaneous fixation with k-wires [21], and 9.09% (n = 1) underwent a two-stage procedure that included fracture curettage, bone graft from iliac crest, and fixation with headless compression screws, first the right side and then the left side after 6 months [25].…”