Diagnostic strategy for suspected scaphoid fractures in the presence of other fractures in the carpal region.
Bone scintigraphy will identify up to 25% of occult scaphoid bone fractures after negative scaphoid X-rays. Consequently, it deserves a place in the diagnostic process of suspected scaphoid fractures. However, the role of bone scintigraphy is less clear if scaphoid X-rays show other fractures in the carpal region. We analysed 111 consecutive patients with a suspected scaphoid fracture on physical examination. Scaphoid X-rays revealed 61 fractures. Fifty-five patients had scaphoid fractures only and six patients had other fractures in the carpal region but no scaphoid fracture. In 50 cases, no bone injury was seen on these X-rays. In three out of the six patients with other fractures in the carpal region, bone scintigraphy revealed four occult concomitant fractures: one scaphoid, one scaphoid and trapezial and one capitate fracture. In conclusion, bone scintigraphy is required when scaphoid X-rays do not confirm a suspected scaphoid fracture, even in the presence of other fractures in the carpal region.
Beeres
F J P
FJ
Department of Trauma Surgery, Medisch Centrum Haaglanden, The Hague, The Netherlands. f.j.p.beeres@umail.leidenuniv.nl
Hogervorst
M
M
Den Hollander
P
P
Rhemrev
S J
SJ
D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries*