Factors associated with union time of acute middle-third scaphoid fractures: an observational study

Abstract

BackgroundThe aim of this study was to investigate the union time of acute middle-third scaphoid fractures following treatments and to analyze the effect of different factors on late union.Patients and methodsWe retrospectively reviewed patients with acute middle-third scaphoid fracture at our institution between January 2013 and December 2017. Patient demographics, fracture characteristics, and treatment strategy, such as age, gender, body mass index, habit of smoking, sides of injury, dominant hand, ulnar variance, multiple fractures, and treatment methods, were investigated. Univariate and multivariate analyses were used to identify possible predictive factors.ResultsA total of 132 patients with scaphoid fracture were included in our study. Operation was performed in 67 patients (50.8%), and conservative treatment was performed in the other 65 patients (49.2%). The union time was 7.2±0.5 weeks. In the multivariate logistic regression analysis, late diagnosis (odds ratio, 1.247; 95% CI, 1.022–1.521) and conservative treatment method (odds ratio, 1.615; 95% CI, 1.031–2.528) were identified as 2 independent predictors of late union in scaphoid fractures patients. Other parameters were not demonstrated to be predictive factors.ConclusionLate diagnosis and conservative treatment were two factors associated with late union. Long time of follow-up is necessary for patient with these factors.

The incidence of surgical intervention following a suspected scaphoid fracture

“…The natural history of the first two groups is well defined, and risk factors for the development of nonunion have been identified. [2][3][4] The natural history of the third group, those that are initially undetectable on plain radiographs, has been poorly defined by the literature. As a result, there is an assumption that the poor outcomes reported in the first two groups equally apply to this group.…”