The wrist consists of a complex structure, including 8 tiny carpal bones and their adjoining soft tissue. The number ofinjuries of the carpal joint is on the increase by accident in leisure or by industrial accident. Carpal bone fracture is often
mistaken as a sprain, which can lead todelayed diagnosis and treatment.
Between 1987 and 1990, 46 scaphid fractures were treated at the department of orthopaedic surgery, Yonsei university medical college. forty patients were available for long term follow-up examination. The follow-up period was from 6 months to 3
years
and 3 months, with an average of 10.4 months.
@ES The results were as follows;
@EN 1. Of all 40 cases, 18 cases(45%) were treated 2 weeks after injury. Therefore, approximately half of the patients missed the opportunity for early proper care.
2. The most frequent site of carpal scaphoid fracture was the mid one-third(65%), and the bony union time was more rapid in transverse fracture followed by horizontal oblique, and lastly vertical oblique fracture.
3. In acute fracture, bony union was obtained in an average of 10.9 weeks in the stable fracture, and 17 weeks in theunstable fracture except one case of nonunion.
4. In acute freacture treated within 2 weeks after injury, bony union was achieved in a mean of 12.1 weeks, which was over 3 weeks shorter than those ofsubacute and chronic fractures.
5. In 20 cases which had surgical intervention, bony union was not influenced by treatment timing after injury, site of fracture, and associated injuries in the same limb.
6. Almost all complications except delayed and nonunion occurred in cases which were after injury. Above findings support theneed for careful initial evaluation and early treatment of carpal scahoid fracture to ensure the best possible chances
for
the
success of treatment.
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