Ipsilateral distal radius and scaphoid fractures

Simultaneous fractures of the distal radius and scaphoid are uncommon. Prev ious reports have outlined a variety of treatment methods for this conditio n. We describe the results in eight patients with simultaneous fractures of the distal radius and scaphoid, who were treated at National Taiwan Univer sity Hospital from 1987 to 1998. Treatments for the distal radius fractures included pin-in-cast in one patient, casting in one, external fixation in one, external fixation after pinning in three, and open reduction with inte rnal fixation in two. Ail scaphoid fractures occurred at the scaphoid waist , and were treated with long-arm thumb spica in three patients, Herbert scr ew fixation in two, and percutaneous pinning in three. All of the fractures united, and none of the patients developed scaphoid avascular necrosis. On e patient suffered from superficial radial nerve injury during external fix ation. The functional results of the wrist were good in five patients and f air in three. To prevent the possible over-distraction of the scaphoid frac ture, fixation of the scaphoid should be performed if a distraction force i s to be applied during the treatment of the distal radius fracture. If no d istraction force is to be applied, a thumb spica may provide adequate fixat ion for the scaphoid fracture.