Pseudarthrosis of the Tubercle of the Scaphoid Bone in Immature Skeleton: Case Report

Abstract

The aim of this study was to present a case report on pseudarthrosis of the scaphoid tubercle, a pathological condition that affects the young and active population. This entity often develops as a result of failure to make an early diagnosis and a late start to treatment. This report describes the case of a 15-year-old patient with a history of a neglected fracture of the scaphoid tubercle that occurred one year earlier and evolved to pseudarthrosis of the tubercle, which is an unusual location for this type of complication. The diagnosis was made from the clinical history and radiographic examination. The treatment was undertaken in accordance with the Matti-Russe technique, by means of a volar route, thus avoiding injury to the scaphoid vascularization, with good clinical and radiographic evolution. Pseudarthrosis of the scaphoid tubercle is a rare condition resulting from a fracture in an unusual location in the scaphoid bone, and it is important because it affects the young and active population. The correct diagnosis is only rarely made by radiologists or surgeons at the time of the fracture, because of failure to recognize this entity. This mistake delays and causes difficulty in treatments for the complications resulting from this kind of fracture. Therefore, it is essential to include this condition in differential diagnoses in order to avoid mistaken conduct. The treatment chosen was shown to be an effective option in this specific case.

Pediatric Scaphoid Nonunions: A Case Series, Review of the Literature, and Evidence-Based Guidelines

“…42,43 Pediatric scaphoid fractures usually occur at 11 to 15 years of age, 1,2,7,13,14,17,23 but fractures have been reported as early as 4 years, though not identified until years later. 26 Most occur through FOOSH, 2,6,7,12,14,44 during sporting activities, punching and fighting, or road traffic related trauma. 1,7 It has been suggested that the incidence of scaphoid fractures will rise with the increased popularity of sports such as skiing and skateboarding and the use of recreational punching games machines, possibly also due to an increase in BMI in children.…”

“…[1][2][3][4][5][6][7][8][9] The scaphoid is affected in 2 to 3% of pediatric hand and wrist fractures, [4][5][6][7]10,11 albeit it is the most often affected carpal bone in the pediatric population (87%). 7 It most commonly affects adolescents between 11 and 17 years of age 2,4,7,10,[12][13][14] and very rarely children younger than 8 years. 2,4,7 These injuries may become more common as children take part in more sporting activities, 7,15-17 and possibly also with an increase in body mass index (BMI).…”