The role of MRI in the assessment of scaphoid fracture healing: a pilot study

Twenty-two patients with fracture of the scaphoid treated by cast immobilis ation underwent clinical examination, radiography and MR scanning 6 weeks a fter injury. On clinical and plain radiographic criteria alone, 12 patients were considered sufficiently healed to warrant mobilisation. The remaining 10 patients were considered unhealed and were immobilised for a further pe riod. A musculoskeletal radiologist, blinded to the clinical diagnosis, rev iewed the MRI scans. Of the 10 patients considered unhealed, 5 had the MR a ppearances of a united fracture based on normal marrow signal across the fr acture line on T1-weighted images. Of the 12 patients deemed to have united , union could be confirmed by MRI criteria in only 5, but all 12 were heale d at 1 year. The results suggest that MRI can provide additional informatio n in this group of patients. It can confirm bony union in a high proportion of patients deemed clinically non-united. Its use in this context will all ow a more rapid mobilisation and return to normal function.,The significanc e of persistent MR signal abnormalities in patients who have clinical and r adiographic signs of healing merits further study.