Carpal Fractures in Children

Carpal fractures in children are uncommon injuries, with the scaphoid being fractured most frequently. Thirty-three children with scaphoid fractures and one child each with fractures of triquetrum, trapezoid, hamate, and capitate were retrospectively reviewed. The mean age was 13 years, 4 months. The mechanism of injury was of low energy in most cases, with >80% of injuries involving a fall. Localizing tenderness was present in 100% of cases. Of fractures, 97.3% were evident on the initial radiographs. One patient required a bone scan to confirm the diagnosis. All but one scaphoid fracture went on to union with conservative treatment in a long-arm thumb spica cast or short-arm thumb spica cast at a mean of 7.1 weeks. All other carpal fractures healed at a mean of 4.5 weeks. The one scaphoid nonunion was attributed to noncompliance by the patient.