SIMULTANEOUS SCAPHOID AND DISTAL RADIAL FRACTURES

Simultaneous fractures of the distal radius and scaphoid are uncommon. In a prospective 3-year study we registered 2,330 distal radial fract ures and 390 scaphoid fractures, and 12 were combined. Ten of these ha d high energy trauma; six were styloid fractures, four Colles' fractur es, one was a greenstick fracture and one Salter-Harris Type 2 epiphys eal fracture. All but one of the 12 scaphoid fractures were stable and healed without problems, and one was a trans-scaphoid, trans-styloid peri-lunate fracture-dislocation. The study supports the opinion that the distal radial fracture constitutes the principal injury that deter mines the outcome and hence the treatment. If the scaphoid fracture is unstable or dislocated, we recommend internal fixation of the scaphoi d. Only a small proportion of these injuries represent a more serious disruption with carpal instability.