The Incidence and Risk Factors of Scaphoid Fracture Associated With Radial Head and Neck Fracture in Trauma Patients

BACKGROUND: Scaphoid and radial head fractures are two injuries derived from the common fall on outstretched hand. How these injuries are related has not been fully investigated. The aim of this study was to evaluate risk factors for having concomitant proximal radius and scaphoid fractures. The goal was to identify at-risk patient populations and drive improvement in diagnosis and management of these injuries. METHODS: A retrospective review of the National Trauma Data Bank from 2007 through 2012 identified 11,309 patients with proximal radius fracture, and, as a proxy for low-energy injury, an injury severity score of less than 15. These patients were then categorized by presence of concomitant scaphoid injury. Presence of scaphoid fracture was then analyzed based on age, sex, race, trauma type, mechanism, and injury severity score. RESULTS: Three hundred seventy-eight (3%) scaphoid fractures among the 11,309 proximal radius fractures were identified. Both age and sex reached statistical significance as risk factors for concomitant scaphoid and radial head injury. There was an incremental increase in risk for concomitant injury with younger age. Subset analysis demonstrated a 10% incidence of concomitant fractures in men aged 18 to 30 years. DISCUSSION: This study provides a better understanding of how these two fractures are related. There is a markedly higher risk for concomitant injuries in male and young patients, especially those whose mechanism is a fall. Close examination of the wrist should be performed for any proximal radius fracture, and any pain should be a cause for further investigation of scaphoid injury.