Clinical utility of tomosynthesis in suspected scaphoid fracture. A pilot study

Geijer, Mats; Börjesson, Annika M.; Göthlin, Jan H.; Börjesson, Annika M; Göthlin, Jan H
July 2011
Skeletal Radiology;Jul2011, Vol. 40 Issue 7, p863
Academic Journal
journal article
Background: Radiography alone will not detect all scaphoid fractures. There is a reported prevalence between 9 and 33% of occult scaphoid fractures. The evidence-based literature suggests that magnetic resonance imaging (MRI) is the most suitable secondary imaging modality due to the ability to evaluate the bone marrow directly and to also identify other injuries. However, there is no consensus on the choice of follow-up imaging strategy-computed tomography, MRI, or bone scan-across different institutions. Tomosynthesis is a new digital tomographic method creating multiple thin tomographic sections. The purpose of this study was to evaluate the clinical utility of tomosynthesis in suspected occult fracture.Methods: Thirty-five patients with a clinically suspected occult scaphoid fracture after initial normal radiography were imaged with repeat radiography and tomosynthesis scan 2 weeks after trauma.Results: Repeat radiography revealed one previously undetected scaphoid tubercle avulsion and one scaphoid waist fracture, confirmed by tomosynthesis. Tomosynthesis revealed two additional scaphoid waist fractures. In total, three initially occult scaphoid waist fractures were detected (9%). No additional fractures were detected in the remaining 32 patients during a 1-year follow-up.Conclusion: Tomosynthesis can demonstrate occult scaphoid fractures not visible at radiography.


Related Articles

  • Musculoskeletal: what is different in children? Playing dodge ball: falls, wrist pain. Swischuk, Leonard // Emergency Radiology;Feb2015, Vol. 22 Issue 1, p79 

    The article describes the case of a 12-year-old male patient who complained of pain and swelling on his left wrist following a dodge ball game. Particular focus is to common fractures of the carpal bones, as well as the patient's mechanism of injury. Topics discussed include radiographic...

  • Test your knowledge: number 10 Scaphoid injuries.  // Emergency Nurse;Jul2009, Vol. 17 Issue 4, p31 

    The article presents a self-assessment questionnaire that tests the reader's knowledge of scaphoid injuries.

  • ACUTE FRACTURES OF THE SCAPHOID. Haisman, J. Mi.; Rohde, Rachel S.; Wetland, Andrew J. // Journal of Bone & Joint Surgery, American Volume;Dec2006, Vol. 88-A Issue 12, p2750 

    The article offers the authors' views on treating acute fractures of the scaphoid bone. Scaphoid is the most commonly fractured carpal bone and it accounts for almost 60 percent of carpal fractures. The author strongly recommends essential repetition of radiographs. One can also opt for computed...

  • Radiographic evaluation of acute scaphoid fractures. Parajuli, B.; Uprety, S. // Journal of Institute of Medicine;Aug2015, Vol. 37 Issue 2, p106 

    Introduction: Scaphoid fracture is the commonest carpal bone fracture. Various radiographic views have been proposed for diagnosing it. This study was conducted to determine which radiographic view/s among five different views showed scaphoid fracture consistently. Methods: This prospective...

  • The occasional scaphoid cast. Brock, Gordon; Tarambikos, Alex // Canadian Journal of Rural Medicine;Fall2003, Vol. 8 Issue 4, p263 

    The common cause of a scaphoid fracture is a fall onto the outstretched hand, involving a forced dorsiflexion and radial deviation. A scaphoid fracture is usually treated with a carefully molded, shortarm cast that includes the proximal phalanx of the thumb, worn for six to twelve weeks. As is...

  • Segmental fracture of the scaphoid: report of a rare fracture pattern. Assunção, RE; Yates, P; Hargreaves, DG // Archives of Orthopaedic & Trauma Surgery;Sep2005, Vol. 125 Issue 7, p479 

    Introduction:To the best of our knowledge, there are no reports in the orthopaedic and trauma literature of true segmental fracture of the scaphoid bone. We present such a case with a brief discussion of the morphology and mechanisms of injury of scaphoid fractures and the problems they present,...

  • The Treatment of Chronic Scapholunate Dissociation: An Evidence-Based Assessment of the Literature. Bloom, Heidi Taylor; Freeland, Alan E.; Bowen, Vaughan; Mrkonjic, Linda // Orthopedics;Feb2003, Vol. 26 Issue 2, p195 

    Discusses a research on the treatment of chronic scapholunate dissociation, which was presented at the 55th Annual Meeting of the American Society for Surgery of the Hand in October 2000. Materials and methods used in the study; Anatomy and pathomechanics of scapholunate dissociation;...

  • Bilateral Trans-Scaphoid Perilunate Fracture Dislocation. Seung-Bum Chae; Jun-Ho Nam // Journal of the Korean Society for Surgery of the Hand;Sep2015, Vol. 20 Issue 3, p127 

    Bilateral trans-scaphoid perilunate fracture dislocations are uncommon and have been rarely reported in the literature. Furthermore, it is more difficult to manage in the case of Fenton's syndrome (scaphocapitate fracture syndrome, trans-scaphoid trans-capitate fracture dislocation). These...

  • Scaphoid Fractures: What's Hot, What's Not. Geissler, William B.; Adams, Julie E.; Bindra, Randy R.; Lanzinger, William D.; Slutsky, David I. // Journal of Bone & Joint Surgery, American Volume;1/18/2012, Vol. 94-A Issue 2, p169 

    The article discusses important facts that orthopaedic surgeons should know about scaphoid fractures. It says that scaphoid fractures can be considered as the most prevalent type of fracture in the carpal bone. According to the authors, around 60 to 70 per cent of carpal fractures are all...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics