[Scaphoid fractures--diagnosis, classification and therapy].

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Abstract

[Indexed for MEDLINE] 6. Eur J Trauma Emerg Surg. 2016 Feb;42(1):3-10. doi: 10.1007/s00068-015-0587-8. Epub 2015 Nov 25. Current concepts for the treatment of acute scaphoid fractures. Arsalan-Werner A(1), Sauerbier M(2), Mehling IM(1). Author information: (1)Department for Plastic, Hand and Reconstructive Surgery, Hand Trauma Center, BG Trauma Center Frankfurt am Main, Academic Hospital Goethe University Frankfurt a. Main, Friedberger Landstrasse 430, 60389, Frankfurt am Main, Germany. (2)Department for Plastic, Hand and Reconstructive Surgery, Hand Trauma Center, BG Trauma Center Frankfurt am Main, Academic Hospital Goethe University Frankfurt a. Main, Friedberger Landstrasse 430, 60389, Frankfurt am Main, Germany. michael.sauerbier@bgu-frankfurt.de. Fractures of the scaphoid are common injuries, accounting for approximately 80 % of carpal fractures. Differentiation between stable and unstable fractures (Herbert classification) cannot be made with conventional X-rays, so evaluation by computed tomography should additionally be performed. Under most circumstances, minimally invasive surgery with cannulated screws is the treatment of choice. A longer cast immobilization after minimal-invasive surgery is not necessary. Conservative treatment still has a place if the fracture is not dislocated nor unstable, but operative treatment can be offered to reduce the period of cast immobilization. Displaced fractures have a greater risk for nonunion and therefore should be treated operatively. Proximal pole fractures are definitely unstable, requiring treatment with screw fixation. The surgical approach depends on the location of the fracture and the preference of the surgeon. DOI: 10.1007/s00068-015-0587-8