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Original Research

Open Access

Accuracy of the radiological protocols in detecting scaphoid fractures, a retrospective study

  • Hassan A. Alshamrani1,*,

1Department of Radiological Sciences, College of Applied Medical Sciences, Najran university, 11001 Najran, Kingdom of Saudi Arabia

DOI: 10.22514/sv.2023.023 Vol.19,Issue 4,July 2023 pp.99-103

Submitted: 02 June 2022 Accepted: 16 September 2022

Published: 08 July 2023

*Corresponding Author(s): Hassan A. Alshamrani E-mail: hamalshamrani@nu.edu.sa

Abstract

Early and accurate diagnosis of scaphoid fractures is vital for improving patient outcomes. However, there is no international agreement on the optimal imaging examination for diagnosing suspected scaphoid fractures. This study aimed to assess the different imaging examinations of scaphoid fractures at three major hospitals in Najran, Saudi Arabia. Radiological strategies for imaging suspected scaphoid fracture were determined using a short cross-sectional survey. The accuracy of the different imaging techniques was compared, and the number of patients with a scaphoid fracture who underwent examination at these hospitals in the past year preceding the start of this study was also investigated. The results showed that plain x-ray was the first line of imaging examination for suspected scaphoid fracture at the three hospitals. When the initial plain x-ray could not rule out scaphoid fracture, a repeated x-ray (10–14 days) was used as second-line imaging in two hospitals, while computed tomography (CT) was used as a third line of imaging. In the third hospital, CT scan was used as the second line of imaging, while magnetic resonance imaging (MRI) was used as the third line of imaging. A total of 112 patients sustained scaphoid fractures in the three hospitals. Initial plain x-ray was able to diagnose 72% of all cases as the first imaging line. Repeated x-ray identified 60% of the fractures that were not detected on the initial plain radiograph, while CT scans identified 88% of the fractures that were not detected on the first plain radiograph. Repeated plain x-rays maybe not be the ideal second-line imaging for scaphoid fracture. The ability of the CT scan to detect scaphoid fracture at an early stage was evident (p = 0.001). Altogether, these results indicate the important role of CT scan in diagnosing scaphoid fracture at an early stage. More studies are warranted to improve the national guidelines for the radiological investigation of scaphoid fractures.


Keywords

Trauma; Fracture; X-ray; Emergency radiology


Cite and Share

Hassan A. Alshamrani. Accuracy of the radiological protocols in detecting scaphoid fractures, a retrospective study. Signa Vitae. 2023. 19(4);99-103.

References

[1] Duckworth AD, Jenkins PJ, Aitken SA, Clement ND, Court-Brown CM, McQueen MM. Scaphoid fracture epidemiology. The Journal of Trauma and Acute Care Surgery. 2012; 72: E41–E45.

[2] Rhemrev SJ, Ootes D, Beeres FJ, Meylaerts SA, Schipper IB. Current methods of diagnosis and treatment of scaphoid fractures. International Journal of Emergency Medicine. 2011; 4: 1–8.

Hackney LA, Dodds SD. Assessment of scaphoid fracture healing. Current Reviews in Musculoskeletal Medicine. 2011; 4: 16–22.

[3] Cheung JP, Tang CY, Fung BK. Current management of acute scaphoid fractures: a review. Hong Kong Medical Journal. 2014; 20: 52–58.

[5] Schmitt R, Rosenthal H. Imaging of scaphoid fractures according to the new S3 guidelines. Advances in the Field of X-rays and Imaging Procedure. 2016; 188: 459–469.

[6] Mallee WH, Walenkamp MMJ, Mulders MAM, Goslings JC, Schep NWL. Detecting scaphoid fractures in wrist injury: a clinical decision rule. Archives of Orthopaedic and Trauma Surgery. 2020; 140: 575–581.

[7] Yin Z, Zhang J, Kan S, Wang X. Diagnosing suspected scaphoid fractures: a systematic review and meta-analysis. Clinical Orthopaedics & Related Research. 2010; 468: 723–734.

[8] Suh N, Grewal R. Controversies and best practices for acute scaphoid fracture management. Journal of Hand Surgery. 2018; 43: 4–12.

[9] Groves AM, Kayani I, Syed R, Hutton BF, Bearcroft PPW, Dixon AK, et al. An international survey of hospital practice in the imaging of acute scaphoid trauma. AJR. American Journal of Roentgenology. 2006; 187: 1453–1456.

[10] Chunara MH, McLeavy CM, Kesavanarayanan V, Paton D, Ganguly A. Current imaging practice for suspected scaphoid fracture in patients with normal initial radiographs: UK-wide national audit. Clinical Radiology. 2019; 74: 450–455.

[11] Mohamed H, Arnander M. Accuracy of the common practice of doing X- rays after two weeks in detecting scaphoid fractures. A retrospective cohort study. Hong Kong Journal of Orthopaedic Research. 2019; 2: 1–6.

[12] Brookes-Fazakerley SD, Kumar AJS, Oakley J. Survey of the initial management and imaging protocols for occult scaphoid fractures in UK hospitals. Skeletal Radiology. 2009; 38: 1045–1048.

[13] Smith JE, House RH, Gallagher J, Phillips A. The management of suspected scaphoid fractures in English hospitals: a national survey. European Journal of Emergency Medicine. 2016; 23: 190–193.

[14] Snaith B, Walker A, Robertshaw S, Spencer NJB, Smith A, Harris MA. Has NICE guidance changed the management of the suspected scaphoid fracture: a survey of UK practice. Radiography. 2021; 27: 377–380.

[15] Smith M, Bain GI, Turner PC, Watts AC. Review of imaging of scaphoid fractures. ANZ Journal of Surgery. 2010; 80: 82–90.

[16] Bäcker HC, Wu CH, Strauch RJ. Systematic review of diagnosis of clinically suspected scaphoid fractures. Journal of Wrist Surgery. 2020; 09: 81–89.

[17] Phillips TG, Reibach AM, Slomiany WP. Diagnosis and management of scaphoid fractures. American Family Physician. 2004; 70: 879–884.

[18] Ozkaya E, Topal FE, Bulut T, Gursoy M, Ozuysal M, Karakaya Z. Evaluation of an artificial intelligence system for diagnosing scaphoid fracture on direct radiography. European Journal of Trauma and Emergency Surgery. 2022; 48: 585–592.

[19] Carpenter CR, Pines JM, Schuur JD, Muir M, Calfee RP, Raja AS. Adult scaphoid fracture. Academic Emergency Medicine. 2014; 21: 101–121.

[20] Beeres FJ, Rhemrev SJ, den Hollander P, Kingma LM, Meylaerts SA, le Cessie S, et al. Early magnetic resonance imaging compared with bone scintigraphy in suspected scaphoid fractures. The Journal of Bone and Joint Surgery. 2008; 90: 1205–1209.


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