ArticleJournal of hand surgery global online2026
Associations Between Area Deprivation Index and the Time to Presentation of Scaphoid Fractures.
Article in Journal of hand surgery global online, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Purpose: Scaphoid fractures are the most common carpal fractures and are prone to nonunion because of their retrograde blood supply. Delayed diagnosis or treatment increases the risk of nonunion and progression to scaphoid nonunion advanced collapse. Social determinants of health, measured by the area deprivation index (ADI), may contribute to such delays. This study examines the association between ADI, time to presentation, and the presence of nonunion at initial evaluation. Methods: A retrospective chart review identified 168 patients with suspected scaphoid fractures between January 1, 2018 and June 30, 2025. State-level ADI scores were grouped into the following terciles: least-deprived (LDT), intermediately deprived (IDT), and most deprived (MDT). Patients presenting more than 5 years after injury or without confirmed fractures were excluded, leaving a total of 107 patients. Independent Results: The mean time from injury to presentation increased with deprivation: LDT = 16.9 ± 23.5 days, IDT = 55.1 ± 97.9 days, and MDT = 173.5 ± 364.5 days. Both MDT and IDT patients presented significantly later than LDT patients ( Conclusions: Patients from socioeconomically deprived communities experienced significantly longer delays in presentation for scaphoid fractures and a higher incidence of nonunion, which may increase the risk of long-term complications such as scaphoid nonunion advanced collapse wrist arthritis. These findings highlight the importance of addressing neighborhood-level disparities to increase access to treatment in time-sensitive injuries such as scaphoid fractures. Type of study/level of evidence: Prevalence IIIb.
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