Radiographic Accuracy in Scaphoid Waist Fractures

Richard C Rooney¹* and Du Preez Smith²

Received: October 16, 2018;   Published: October 23, 2018

DOI: 10.32474/OSMOAJ.2018.02.000130

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Abstract

Objectives: We compared CT scanning and radiographic imaging to determine the relationship between measurements of displacement and angulation of the fracture.

Design: X-ray review.

Methods: All patients with acute scaphoid fractures treated at our hospital in a 4-year period that had a CT scan and plain radiographs were evaluated. The maximum displacement seen on either AP or lateral X-rays was measured as well as the amount of palmar flexion through the fracture as seen on the lateral X-ray. The differences were calculated and the mean of the sum of the differences was calculated.

Results: 103 patients radiographic files were evaluated and 43 were found to have CT scans through the longitudinal axis of the scaphoid as well as AP and lateral plain radiographs taken within one week of the CT in acute fractures. The average displacement seen on the CT was 1.85mm with an average of 50.9 degrees of palmar flexion through the fracture. The average displacement and angulation on the plain radiographs were .93mm and 33.2 degrees respectively. The mean difference in displacement and angulation between the CT scan and plain radiographs was 1.39mm (p=0.003) and 17.9 degrees (p=0.013) respectively. These were statistically significant using paired t-test comparison.

Conclusion: We believe that the accurate assessment of scaphoid fractures is essential to ensure the most appropriate treatment is rendered. We feel that CT scanning should be used to evaluate all acute scaphoid fractures to ensure that the most reliable determination of displacement can be made, and the most effective treatment rendered.

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