Radiography and scintigraphy of suspected scaphoid fracture. A long-term study in 160 patients.
Radiographs of the scaphoid after injury are difficult to interpret, and bone scintigraphy is widely used to increase the accuracy of diagnosis, though many fractures suspected on scintigraphy cannot be confirmed radiologically. We have reviewed the clinical consequences, after one year, of managing suspected scaphoid fractures according to the bone-scan results. We studied 160 patients, 35 of whom had initially positive radiographs and were treated in a cast for 12 weeks. The other 125 had bone scintigraphy and were managed according to the result. After a minimum of one year 119 patients were reviewed. Scintigraphically suspected scaphoid fracture could not be confirmed radiologically in 25%. There were no cases of nonunion. The long period of immobilisation in patients with positive radiographs or positive bone scans did not influence the frequency or severity of late symptoms compared with those with a normal bone scan.
Tiel-van Buul
M M
MM
Academic Medical Centre, University of Amsterdam, The Netherlands.
van Beek
E J
EJ
Broekhuizen
A H
AH
Bakker
A J
AJ
Bos
K E
KE
van Royen
E A
EA
D000293:Adolescent; D000328:Adult; D000368:Aged; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D002648:Child; D002985:Clinical Protocols; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011877:Radionuclide Imaging; D013669:Technetium Tc 99m Medronate
D013669:Technetium Tc 99m Medronate