Radiographic evaluation of acute scaphoid fractures

Abstract

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 study was carried out in Department of Orthopedics, IOM, TUTH from February 2012 to June 2013. Twenty-six patients with scaphoid fracture were included in the study who had five scaphoid views done viz. postero-anterior, ulnar deviated PA, pronation oblique, supination oblique and lateral. Each view was assessed with respect to demonstrating a fracture and the clarity of demonstration. Statistical analysis of data obtained was done using SPSS 17.0 version.

Results: This study included 26 patients, 18 to 54 years of age (27.5±9.5 years). Average duration after injury was 6.73± 8.64 days. Out of five different views, pronation oblique showed fracture in 69.2% of patients followed by ulnar deviated PA in 61.5% patients. Pronation oblique showed fracture in all patients who had demonstrated fracture in supination oblique and lateral views also. Pronation oblique and ulnar deviated PA were the only views to show fracture in 5 patients each. Fracture in middle 1/3^rd of the scaphoid was present in 53.8% patients while no patients had proximal 1/3rd fracture.

Conclusion: Pronation oblique and ulnar deviated PA are the most important views among the other views of scaphoid series. Supination oblique and lateral views are the least important views to detect a scaphoid fracture.