Make up less than 0.34% of all pediatric fractures
Scaphoid fractures may be missed 12.5% - 37% on the initial presentation.
30% of patients will have an radiographically apparant fracture on repeat films done 2 weeks later.
These physical exam findings are more specific for fracture:
Volar tenderness over the scaphoid
Pain with radial deviation
Pain with active wrist range of motion.
Though snuff box tenderness was seen in 100% of patients eventually proven to have a fracture, it was also seen in 92% of the patients that did not have a fracture at follow-up making it non-specific but sensitive.
Because of the high (30%) fracture rate seen on followup films it is recommended that all children be placed into a thumb spica splint until followed up.
