An Unusual Case Of Spontaneous Healing Of A Proximal Pole Scaphoid Non-union
Park, M. J., Lee, A. T., & Yao, J. (2011). An unusual case of spontaneous healing of a proximal pole scaphoid non-union. Hand (New York, N.Y.), 6(3), 313–316. https://doi.org/10.1007/s11552-011-9328-6
View Original Source →Abstract
Minimally displaced scaphoid fractures may be treated effectively with non-operative treatment strategies [1, 6]. However, delayed diagnosis of a scaphoid fracture may frequently lead to non-union, especially if the fracture is in the proximal portion of the scaphoid [4, 11]. Proximal pole scaphoid fractures commonly result in non-unions secondary to disruption of the retrograde blood flow. Although proximal pole scaphoid fractures may heal spontaneously, the fracture location leads to non-union in the majority of the cases without surgical intervention. Based on our literature review, there has not been a report of spontaneous healing of an established proximal pole scaphoid non-union. Here, we present an unusual case of healing of a proximal pole scaphoid fracture without surgical intervention or immobilization.
Case Details
Disease Location
Primal pole scaphoid nascent frature (ultimate frisbee injury) in may 2005
Personal Characteristics
23-year-old right-hand-dominant male
Clinical Characteristics
Wrist discomfort with activity at examination 3 months after injury (august 2005); at 6 months follow-up (november 2005), mild tenderness in the natomic snuffbox but no evidence of instability based on provocative testing of the scapholunate interval; range of motion was slightly decreased in extension and radial deviation, no gross carpal instability, wrist flexion and ulnar deviation were symmetrical, MRI confirmed scaphoid non-union
Remission Characteristics
In may 2007, radiographs showed healing of proximal pole scaphoid fracture and again 6 months after that (november 2007) with no symptoms and full range of motion of the wrist
Treatment & Mechanisms
Proposed Remission Mechanisms
Favorable factors noted: radiographs showed normal trabecular bone and vascular bone marrow; patient was young, non-smoker, had type 2 lunate with minimally displaced scaphoid fracture with no evidence of carpal instability, pain free
Clinical Treatment
None reported stated
Non-Clinical Treatment
None reported stated