Epidemiology of carpal fractures: is it only about the scaphoid?

Abstract

Because of their low incidence, studies about carpal fractures are rare. The aim of the present study was to analyze epidemiology and treatment of fractured carpal bones. We retrospectively analyzed data of 178 patients admitted to our emergency room with carpal fractures over 6 years. More males than woman were injured. In 91%, a CT scan was performed. The most commonly affected bone was the triquetrum followed by the scaphoid. Almost all triquetral fractures were treated conservatively as opposed to perilunate dislocations that were all operated on. Half of all patients with scaphoid fractures were operated. Young men had the highest risk to sustain a carpal fracture. The triquetrum and the scaphoid are most frequently affected. Usually a CT scan is needed. Treatment of scaphoid and perilunate luxation fractures is rather operative whereas the other fractures mostly allow conservative casting. Nevertheless, correct indication for treatment is important to avoid sequelae.

Hamate Fracture

“…Hamate fractures are often seen in emergency departments (Sanderson et al, 2020), and can lead to significant complications and negative patient outcomes if not identified and managed in a timely manner (Boeddrich et al, 2023; Cecava et al, 2017). It is vital for advanced practice nurses working in emergency settings to be knowledgeable of hamate fractures and their common presentations.…”

“…Hamate fractures are most commonly seen in young adult males (Price et al, 2021). Typical mechanisms of injury include trauma from a sports-related injury, often swing-related (Bansal et al, 2017), a punch injury, a crush injury, or, most commonly, a fall on an outstretched and extended hand (Boeddrich et al, 2023;Petering, 2020;Price et al, 2021). Patients with hamate fractures may present with sudden pain in the ulnar palmar region or at the back of the wrist distal to the ulna (Petering, 2020).…”

“…RACTURES OF THE CARPAL bones often present to emergency departments (Sanderson et al, 2020). Carpal fractures have a lower incidence than other hand fractures (Boeddrich et al, 2023), and are underdiagnosed (Petering, 2020). Hamate fractures are estimated to account for approximately 2%-4% of carpal fractures (Janssen et al, 2022;Price et al, 2021).…”

“…Hamate fractures are estimated to account for approximately 2%–4% of carpal fractures (Janssen et al, 2022; Price et al, 2021). Though less common than scaphoid and triquetral carpal fractures (Whipple, 2019), hamate fractures must not be overlooked, as delayed diagnosis can lead to complications and negative patient outcomes (Boeddrich et al, 2023; Cecava et al, 2017). Hamate fractures can be challenging to diagnose (Cecava et al, 2017).…”

The Canadian Prospective Pragmatic Perilunate Outcomes (C3PO) Trial; A Protocol

“…These injuries are considered uncommon; however, the true incidence is unclear. One estimate indicates PSIs represent less than 10% of all carpal injuries (3), while another estimated PLFDs made up 3.9% of carpal fractures (4). These values remain uncertain, as there is a high reported missed injury rate of 25-27% (5,6).…”