BACKGROUND: Scaphoid fractures are common carpal injuries among adults, though their optimal management may differ based on patient demographics. While these fractures often result from high-energy trauma in younger patients, low-energy mechanisms predominate in older adults, who are frequently treated nonoperatively due to concerns regarding bone quality and healing potential. Recent studies suggest that factors other than age more strongly influence patient outcomes, indicating older adults may benefit from surgical fixation over conservative management. This study evaluated outcomes following surgical fixation of scaphoid fractures to determine whether age alone should influence surgical decision-making.
METHODS: This retrospective study included 26 patients (13 aged ≥60 years and 13 matched controls aged 30-49 years) who underwent surgical fixation for scaphoid fractures. Demographic, radiographic, and clinical variables were analyzed to assess incidence of nonunion, complication rates, and time to radiographic union.
RESULTS: Radiographic union was confirmed in 12 (92.3%) elderly patients and 13 (100%) controls. One elderly patient developed scaphoid nonunion requiring reoperation. Mean time to radiographic union did not differ significantly between elderly and control cohorts (9.0 ± 2.3 vs 9.2 ± 2.4 weeks, P = .78). Time to radiographic union was not significantly associated with age, carpometacarpal arthritis, or osteoporosis.
CONCLUSIONS: Surgical fixation of scaphoid fractures in adults aged ≥60 years yields union rates and complication profiles similar to younger patients. These findings challenge the traditional assumption that advanced age precludes surgical management and support operative fixation as a safe and effective option in appropriately selected older adults.
Read the article: PubMed · Publisher (DOI)