gms | German Medical Science

Objective: There is no consensus on the optimum timing for C/T use to confirm the diagnosis of scaphoid fractures among patients with suspected scaphoid fractures and normal radiographic findings. Computed tomography (CT) is usually used 10 days after a trauma and persistent pain for the diagnosis of scaphoid fractures.The necessity of immediate evaluation of a suspected scaphoid fracture with C/T after a wrist trauma in athletes.

Material/Methods: Thirteen athletes after a fall on their outstretched hand and pain on the scaphoid bone area had visited our emergency department. They had normal radiographic findings. Seven of them with such wrist injury immediately underwent a carpal C/T (group A) and the other six with same wrist injury after ten days (group B). The reference standard for a true fracture of the scaphoid was visible in sagital or coronal views. The images were considered in random order by the same radiologist.

Results: Non dislocated scaphoid fracture was detected in four of seven athletes with carpal C/T (group A). The athletes in group B who underwent carpal C/T ten days after the trauma (group B) demonstrated a non dislocated scaphoid fracture in five patients. There were no athletes with dislocated scaphoid fracture.

Conclusion: Carpal CT was very critical because of early diagnosis of non dislocated scaphoid fractures with normal radiographic findings. The early diagnosis is very important for the athlete population in order to reduce the time of recovery after a wrist trauma. This study could not confirm that early CT imaging was a superior examination compered to MRI and scintigraphy which has less or no radiation.