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Established scaphoid nonunion progressing to spontaneous union in a child

Clarke, Jon V. and Ramjug, Sheala D. and Barnes, Steven J. (2006) Established scaphoid nonunion progressing to spontaneous union in a child. Injury Extra, 37 (4). pp. 170-171. ISSN 1572-3461

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Scaphoid fractures in children are uncommon and account for approximately 0.38% of paediatric fractures. Prompt and adequate immobilisation in a scaphoid cast is necessary for successful treatment. Virtually all scaphoid fractures in children will unite with such conservative measures. We report a case of an established scaphoid nonunion in an 11-year-old child, which spontaneously united 2 years after the initial injury. There appear to be no similar cases in the literature. There is one reported case in an adult, but this represents a separate patient group which behaves differently due to skeletal maturity. This case highlights the importance of appropriate orthopaedic follow-up and radiological examination in a child with a clinical suspicion of a scaphoid fracture, in order to prevent progressive arthritis and nonunions warranting surgical intervention.