SCAPHOID FRACTURE - A NEW METHOD OF ASSESSMENT

The value of colour flow Doppler ultrasound scanning in patients with suspected acute carpal scaphoid fracture has been examined. A prospect ive study of 78 patients with signs and symptoms of carpal scaphoid in jury was undertaken over a period of 6 months. Both wrists of all pati ents were scanned within 12-72 h of injury. The radial artery and carp al scaphoid bone contours are visible using this type of imaging techn ique. The distance between the medial wall of the radial artery and th e outer cortex of the scaphoid waist was measured. The scaphoid index is described and was calculated from this measurement. Patients were m anaged without knowledge of the ultrasound imaging result, using plain radiographs and clinical examination as the standard for determining the presence of a scaphoid fracture. All patients were followed to the resolution of symptoms. All 12 patients who were subsequently conside red to have scaphoid fractures were identified using this imaging tech nique within 12-72 h after injury. We conclude that this imaging may b e useful in the assessment of patients with carpal scaphoid fracture. It can be used early, as a supplementary investigation, in patients wi th suspected carpal scaphoid fracture in whom the initial plain radiog raphs are normal.