Diagnostic strategy for suspected scaphoid fractures in the presence of other fractures in the carpal region

J Hand Surg Br. 2006 Aug;31(4):416-8. doi: 10.1016/j.jhsb.2006.04.007. Epub 2006 May 22.

Abstract

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.

MeSH terms

  • Carpal Bones / diagnostic imaging
  • Carpal Bones / injuries*
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / epidemiology*
  • Humans
  • Predictive Value of Tests
  • Radiography
  • Retrospective Studies
  • Scaphoid Bone / diagnostic imaging
  • Scaphoid Bone / injuries*