Objective: To know about the causes of delayed diagnosis and nonunion of scaphoid fractures.
Methods: This study was conducted at the department of Orthopedic and Spine Surgery, Haytabad Medical Complex, Peshawar from January 2018 to December 2022. The study included 38 scaphoid non unions who presented more than 3 months of trauma and had no signs of union clinically and radiologically. Their clinical data were recorded with history of trauma, initial presentation, investigations and any treatment received.
Results: Out of 38 patients, 29 were male and 9 females. Mean age was 29 years (range 18-63). The average duration of fracture at the time of presentation was 15 months. At the time injury, 22 patients were seen by orthopaedic surgeons within a week of trauma. Only 12 were diagnosed as scaphoid fracture at the time of injury and had proper immobilization for sufficient time (4-6 weeks). Only three patients had MRI scan and one patient had bone scan before presenting to us. Among the 22 patients initially seen by orthopaedic surgeons, 10 fractures were missed.
Conclusions: Scaphoid fracture diagnosis is delayed and non union occurs if no proper diagnostic protocol is followed, even by orthopaedic surgeons. Wrist injuries should be evaluated with proper clinical examination and radiological work up to minimize chances of complications.
Key words: Scaphoid nonunion, scaphoid fracture, wrist injuries, scaphoid xrays.
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