Scaphoid pseudoarthrosis in an adolescent: a case report
DOI:
https://doi.org/10.37497/JMRReview.v5i00.1462Keywords:
Pseudoarthrosis, Scaphoid, Adolescent, Osteosynthesis, Herbert Screw, WristAbstract
Background: Scaphoid pseudoarthrosis in adolescents is an uncommon complication, usually related to late diagnosis or lack of adequate treatment of the initial fracture. The injury can compromise bone consolidation and cause functional limitations, making early recognition and appropriate choice of therapeutic approach fundamental.
Aim: To report a case of scaphoid pseudoarthrosis in an adolescent, highlighting the diagnosis, surgical treatment, and functional evolution.
Method: This is a descriptive, retrospective, case report study, conducted at the São Francisco na Providência de Deus University Hospital (HUSF), in Bragança Paulista, SP. Data from the medical record were analyzed, including clinical history, imaging exams, diagnosis, surgical treatment, and postoperative evolution of the patient.
Results: A 14-year-old male patient presented with persistent pain in his left wrist after a fall from his own height while skateboarding, initially without a fracture diagnosis. Approximately three months after the trauma, orthopedic evaluation identified a scaphoid fracture with delayed consolidation, classified as pseudoarthrosis. Osteosynthesis with a Herbert screw was performed, with favorable evolution, complete fracture consolidation, and functional recovery of the affected limb after postoperative follow-up.
Conclusion: Scaphoid pseudoarthrosis in adolescents can present diagnostic difficulties and progress to consolidation alterations when not recognized early. In the present case, osteosynthesis with a Herbert screw after late diagnosis resulted in complete consolidation and functional recovery, reinforcing the importance of recognizing the lesion and the appropriate therapeutic approach for preserving wrist function.
References
ANDRE, Constance et al. Functional and radiologic outcomes of non-displaced scaphoid waist fractures in adolescents approaching skeletal maturity: Comparison between conservative treatment and percutaneous screw fixation. Orthopaedics & Traumatology: Surgery & Research, v. 110, n. 6, p. 103636, 1 out. 2024.
BAE, Donald S. et al. Functional Outcomes After Treatment of Scaphoid Fractures in Children and Adolescents. Journal of Pediatric Orthopedics, v. 36, n. 1, p. 13–18, jan. 2016.
BANDINELLI, Diletta et al. Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique. Children, v. 12, n. 9, p. 1135, 27 ago. 2025.
GAUSE, T. M. et al. Scaphoid Waist Nonunion in an 8-Year-Old: A Rare Occurrence. Case Reports in Orthopedics, v. 2019, p. 4701585, 14 out. 2019.
KAEMPF, Ricardo et al. Minimally Invasive Arthroscopic Fixation of Scaphoid Nonunion in Adolescents Shows High Union Rates, Improved Function, and Low Morbidity. Arthroscopy, Sports Medicine, and Rehabilitation, v. 8, n. 1, p. e70008, fev. 2026.
LIN, James S.; GRENIER, Gregory; BALCH SAMORA, Julie. Outcomes of Pediatric Scaphoid Nonunions Treated With Distal Radius Cancellous Autograft. Journal of Pediatric Orthopedics, v. 42, n. 5, p. 260–264, 1 jun. 2022.
LIN, James S.; MACDONALD, James; BALCH SAMORA, Julie. Pediatric Scaphoid Nonunions: Does Insurance Status Play a Role? Journal of Pediatric Orthopedics, v. 45, n. 2, p. 64–67, 1 fev. 2025.
PATEL, Vandan S. et al. Pediatric scaphoid fractures: predictors of surgery and fracture complications. Skeletal Radiology, v. 55, n. 4, p. 747–755, abr. 2026.
SAGLAM, Fevzi; BAYSAL, Ozgur. Is physical examination as effective as magnetic resonance imaging in the diagnosis of suspected pediatric scaphoid fractures? Northern Clinics of Istanbul, v. 8, n. 5, p. 507–512, 18 out. 2021.
ZEHNER, Katie M. et al. Incidence, Risk Factors, Management, and Nonunion Rates of Pediatric Scaphoid Fractures: A National Database Study. Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews, v. 10, n. 7, p. e26.00106, 1 jul. 2026.
