A 19-year-old male who played as a football goalkeeper visited our hospital with complaints of sustained pain from the right wrist to the hand after punching a ball. In the emergency department, the patient exhibited swelling at the right wrist and tenderness at the anatomical snuffbox of the right wrist and second metacarpal base area.
Plain radiographs of the right wrist showed a displaced scaphoid body fracture (type 2B according to the Herbert classification). No other fractures could be identified on plain radiographs (Figure 1). Computed tomography (CT) scan was performed for the right wrist to obtain details on the fractured scaphoid. In addition to the displaced scaphoid body fracture, the CT scan revealed a displaced trapezoid fracture that was not clearly observed on plain radiographs. The fracture pattern of the trapezoid was vertical (Figure 2).
Surgery was performed at 11 days after the patient's initial hospital visit. Open reduction and internal fixation of the fractures was performed with two 1 cm minimal incisions over the scaphoid and trapezoid using a cannulated headless compression screw (double-threaded screw; MEIRA Corporation, Nagoya, Japan) for each fracture (Figure 3). After surgery, the patient's right wrist was placed in a short-arm thumb spica cast for 2 weeks. Range of motion exercise was initiated at 2 weeks after surgery. The fracture line was still visible in the scaphoid, but most part of the fracture site was united at 5 months after surgery (Figure 4). The patient returned to play as a football goalkeeper and is currently free of symptoms.