Scaphoid Fractures in Children

Fractures of the scaphoid bone are uncommon in children, representing only 0.34% of all children’s fractures (D’Arienzo et al., 1977). This is probably because its ossification centre is protected by thick peripheral cartilage. The ossific nucleus of the scaphoid usually appears at 5–6 years of age and enchondral ossification is complete by 13–15 years (Tachdjian, 1972). Scaphoid fractures in children can be classified into three types (Table 1), based on their radiographic features and stage of ossification. Type 1 is a pure chondral fracture, and occurs in children aged 8 years or less. It is very rare and can only be diagnosed with an MRI or CT scan. Type 2 is an osteochondral fracture and occurs between 8 and 11 years of age. It is also a rare injury. In contrast, Type 3 injuries, which occur when the ossification centre is well developed (over the age of 12 years) are the most common. Types 1 and 2 fractures, if not suspected, diagnosed and treated appropriately, may progress to nonunion (Fabre et al., 2001). Scaphoid fractures in children most frequently involve the distal third of the bone, and avulsion or tubercle fracture are considered the most frequent (Mussbichler, 1961; Vahvanen and Westerlund, 1980). The 39 scaphoid fractures in children treated in the Orthopaedic and Traumatology Department of the University of