Age-dependent changes in pediatric scaphoid fracture pattern on radiographs

• Published in: Skeletal radiology 2020-12, Vol.49 (12), p.2011-2018
• Main Authors: Nguyen, Jie C., Nguyen, Michael K., Arkader, Alexandre, Guariento, Andressa, Sze, Alyssa, Moore, Zonia R., Chang, Benjamin
• Format: Article
• Language: English
• Subjects: Age; Children; Fractures; Hand; Horizontal orientation; Imaging; Injuries; Medical colleges; Medicine; Medicine & Public Health; Nuclear Medicine; Orthopedics; Pathology; Pediatrics; Radiographs; Radiography; Radiology; Scientific Article
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-020-03522-9

Objective To systematically investigate age-dependent changes in scaphoid fracture prevalence and fracture patterns on radiographs in children under 15 years of age. Methods and Materials This retrospective study included children with scaphoid fractures, who underwent radiographic examinations between May 1, 2009, and August 31, 2019. Blinded to outcome, all radiographs were reviewed to determine fracture visibility on initial radiographs; to characterize fracture location (distal corner, distal, mid, and proximal body) and orientation (horizontal oblique, transverse, and vertical oblique); and to identify the presence or absence of gap, displacement, and concomitant fractures. Demographic information and information on weight and height were collected. Mann-Whitney U , Kruskal-Wallis rank sum, chi-square, and post hoc tests were used to investigate associations between age, fracture characteristics, and BMI percentile. Results The study included 180 children (134 boys and 46 girls; 12.3 ± 1.4 years) with 59 (33%) distal corner, 42 (23%) distal, 76 (42%) mid, and 3 (2%) proximal body fractures. Younger children were more likely to present with distal corner and distal body fractures while older children with mid and proximal body fractures ( p  = 0.035). No association was found between age and fracture visibility ( p  = 0.246), fracture orientation ( p  = 0.752), presence of gap ( p  = 0.130), displacement ( p  = 0.403), or concomitant fractures ( p  = 0.588). Younger children with scaphoid fractures were more likely to be obese ( n  = 117; p  = 0.038). Conclusion Scaphoid fractures of the distal corner and distal body were significantly more common in younger children, who are more likely to be obese.