title: Conservative treatment of scaphoid nonunion in children and adolescents.
abstract: This is a retrospective study of six children with ununited scaphoid fractures treated conservatively. Their mean age was 12.8 years (9.7 to 16.3). Five had no early treatment. Radiological signs of nonunion were found at a mean of 4.6 months (3 to 7) after injury. Treatment consisted of cast immobilisation until clinical and radiological union. The mean clinical and radiological follow-up was for 67 months (17 to 90). We assessed the symptoms, the range of movement of the wrist and the grip strength to calculate the Modified Mayo Wrist score. The fracture united in all patients after a mean period of immobilisation of 5.3 months (3 to 7). Five patients were pain free; one had mild pain. All returned to regular activities, and had a range of movement and grip strength within 25% of normal, resulting in an excellent Modified Mayo Wrist score. Prolonged treatment with cast immobilisation resulted in union of the fracture and an excellent Modified Wrist Score in all patients.
authors.affiliation: Department of Hand Surgery, Orthopaedic Department, Children's University Hospital, Steinwiesstrasse 75, Zurich CH-8032, Switzerland. Daniel.Weber@kispi.uzh.ch
authors.forename: D M
authors.initials: DM
authors.lastname: Weber
authors.forename: R
authors.initials: R
authors.lastname: Fricker
authors.forename: L E
authors.initials: LE
authors.lastname: Ramseier
mesh_terms: D000293:Adolescent; D002370:Casts, Surgical; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000293:injuries*; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000628:therapy*