Occult Pediatric Scaphoid Injuries

Abstract

Fractures of the scaphoid may not be evident on the initial radiographic examination. They may be diagnosed in a late stage from the radiographic signs of bone healing. The diagnosis and treatment of children presenting with residual pain, swelling and tenderness on palpation in the anatomical snuffbox following either scaphoid injuries or distal forearm fractures after 5, at least, weeks of immobilization represent a true diagnostic dilemma. The use of a limited MRI with fat-suppression may indicate bone bruises of the carpal bones and/or of the scaphoid in these children. Prolonged immobilization and protection, until complete resolution of the clinical symptoms and signs, is the only required treatment.

Scaphoid Fractures in Children: Particulararities and Difficulties of Diagnosis and Treatment

“…MRI shows us especially the chondral and osteochondral fractures, where radiological images are not reliable. Scaphoid fractures may remain undiagnosed at the initial radiographic examination and we may be surprised to see that in a late stage we find the presence of fracture, based on radiographic signs, given by the bone regeneration reaction [18].…”