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Scaphoid Fractures in Children:
- Rare before the age of 11.
- Make up less than 0.34% of all pediatric fractures
- Scaphoid fractures may be missed 12.5% - 37% on the initial presentation.
- 30% of patients will have an radiographically apparant fracture on repeat films done 2 weeks later.
- These physical exam findings are more specific for fracture:
- Volar tenderness over the scaphoid
- Pain with radial deviation
- Pain with active wrist range of motion.
- Though snuff box tenderness was seen in 100% of patients eventually proven to have a fracture, it was also seen in 92% of the patients that did not have a fracture at follow-up making it non-specific but sensitive.
Because of the high (30%) fracture rate seen on followup films it is recommended that all children be placed into a thumb spica splint until followed up.
References
Evenski AJ, Adamczyk MJ, Steiner RP, Morscher MA, Riley PM. Clinically Suspected Scaphoid Fractures in Children. J Pediatr Orthop 2009; 29: 352-355.