Scaphoid fracture detection in a military population: a standardized approach for medical referral.
OBJECTIVE
The objective was to test, refine, and implement an algorithm for early detection and referral of clinical scaphoid fractures by U.S. Army medical personnel. Our goal was to reduce complications resulting from delayed diagnosis and to improve outcomes affecting soldier health and unit readiness.


METHODS
Data on scaphoid fractures treated in the orthopedic department at Tripler Army Medical Center were collected from January 1, 2001, through December 31, 2003. Demographic variables included gender, age, and military rank.


RESULTS
The incidence of scaphoid fractures in our population was 43 cases per 100,000 personnel per year. An algorithm to guide nonorthopedic providers was developed after review of the medical literature.


CONCLUSIONS
We present an algorithm-based approach to soldiers presenting with post-traumatic wrist pain. The algorithm was fashioned with the aim of reducing complications and poor outcomes associated with delayed diagnosis of scaphoid fractures, affecting soldier health and unit readiness. A prospective study of the algorithm is underway.
Burtis
Michael T
MT
Department of Radiology, Tripler Army Medical Center, Honolulu, HI 96818, USA.
Faillace
John
J
Martin
Leslie F
LF
Hermenau
Shawn
S
D000293:Adolescent; D000328:Adult; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008889:Military Personnel; D012017:Referral and Consultation / Q000592:standards*; D021361:Scaphoid Bone / Q000033:anatomy & histology / Q000098:blood supply / Q000503:physiopathology*; D014481:United States