title: Displaced scaphoid waist fractures: the use of a week 4 CT scan to predict the likelihood of union with nonoperative treatment.
abstract: This study assessed whether nonunion of displaced scaphoid waist fractures with nonoperative treatment could be predicted from 4 week CT scans. Thirty-one patients with unilateral displaced scaphoid waist fractures and adequate follow-up were included. CT scans in the longitudinal axis of the scaphoid with sagittal and coronal slices were done 4 weeks after the index injury. The effects of fracture gap, sclerosis and bone resorption on union were assessed. Fracture union was observed in all 13 displaced fractures with a < 2 mm gap, four of the seven with a gap of 2-3 mm and only four of the 11 with a gap > 3 mm (p = 0.01). Bone resorption involving more than 50% of the fracture cross-section was also associated with nonunion, but sclerosis was not.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Queens Medical Centre, University Hospital, Nottingham, UK.
authors.forename: R
authors.initials: R
authors.lastname: Amirfeyz
authors.forename: A
authors.initials: A
authors.lastname: Bebbington
authors.forename: N D
authors.initials: ND
authors.lastname: Downing
authors.forename: J A
authors.initials: JA
authors.lastname: Oni
authors.forename: T R C
authors.initials: TR
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D002370:Casts, Surgical; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology*; D005599:Fractures, Ununited / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019233:Retreatment; D021361:Scaphoid Bone / Q000000981:diagnostic imaging* / Q000293:injuries* / Q000601:surgery; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult