Js. Dawson et al., Scaphoid blood flow and acute fracture healing - A dynamic MRI study with enhancement with gadolinium, J BONE-BR V, 83B(6), 2001, pp. 809-814
Citations number
40
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
We have investigated whether assessment of blood flow to the proximal scaph
oid can be used to predict nonunion in acute fractures of the scaphoid. We
studied 32 fractures of the scaphoid one to two weeks after injury, by dyna
mic fat-suppressed T1-weighted gradient-echo MRI after the intravenous admi
nistration of gadopentetate dimeglumine (0.1 mmol/kg body-weight). Steepest
slope values (SSV) and percentage enhancement values (%E) were calculated
for the distal and proximal fragments and poles. All the fractures were tre
ated by immobilisation in a cast, and union was assessed by CT at 12 weeks.
Nonunion occurred in four fractures (12%), and there was no statistically s
ignificant difference between the proximal fragment SSV and %E values for t
he fractures which united and those with nonunion. The difference between t
he proximal pole SSV and %E values for the union and nonunion groups reache
d statistical significance (p < 0.05), but with higher enhancement paramete
rs for the nonunion group. Our results suggest that poor proximal vasculari
ty is not an important determinant of union in fractures of the scaphoid.