The role of MRI in the assessment of scaphoid fracture healing: a pilot study.
Twenty-two patients with fracture of the scaphoid treated by cast immobilisation underwent clinical examination, radiography and MR scanning 6 weeks after injury. On clinical and plain radiographic criteria alone, 12 patients were considered sufficiently healed to warrant mobilisation. The remaining 10 patients were considered unhealed and were immobilised for a further period. A musculoskeletal radiologist, blinded to the clinical diagnosis, reviewed the MRI scans. Of the 10 patients considered unhealed, 5 had the MR appearances of a united fracture, based on normal marrow signal across the fracture line on T1-weighted images. Of the 12 patients deemed to have united, union could be confirmed by MRI criteria in only 5, but all 12 were healed at 1 year. The results suggest that MRI can provide additional information in this group of patients. It can confirm bony union in a high proportion of patients deemed clinically non-united. Its use in this context will allow a more rapid mobilisation and return to normal function. The significance of persistent MR signal abnormalities in patients who have clinical and radiographic signs of healing merits further study.
McNally
E G
EG
Department of Radiology, Nuffield Orthopaedic Centre and Oxford Radcliffe Hospital, Headington, UK.
Goodman
R
R
Burge
P
P
D000328:Adult; D005260:Female; D017102:Fracture Healing; D050723:Fractures, Bone / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010865:Pilot Projects; D021361:Scaphoid Bone / Q000293:injuries* / Q000473:pathology