The scaphoid is the most frequently injured carpal bone,
mostly due to a fall on an outstretched hand.
Scaphoid fractures are often occult on initial radiographs.
Since scaphoid fractures may be implicated bya process of non-union with instability,
patients with suspected fractures will be immobilized routinely,
until (repeat) imaging confirms or denies the presence of a fracture [1,2].
This approach will however result in needless immobilization in a number of patients,
having a negative impact on their daily activity and representing...
Methods and Materials
139 patients (Male/female: 80/59; age range 7-83 years),
clinically suspicious for scaphoid fracture,
were examined within 6 days after the event with radiographs,
followed by a CBCT examination.
A series of three standard projection views (posteroanterior,
lateral and posteroanterior view with ulnar deviation) was performed.
The CBCT was performed on a NewTom 5G CBCT scanner (QR,
Italy) with the patient sitting behind the gantry,
with the arm in horizontal position through the gantry opening,
with wrist and hand fixated in order to prevent motion artifacts....
In 20 patients,
a fracture seen on conventional radiographs is confirmed upon CBCT.
In 33 out of 89 patients (i.e.
in 37 %) who were initially scored negative on radiographs,
at least 1 carpal fracture was detected on CBCT (16 scaphoid,
5 hamulus of the hamate,
and one capitate,
one lunate ,
and in 3 patients a combination of lunate,
or hamate fractures).
37 fractures were detected in this subgroup initially being interpreted...
CBCT is a new low-dose imaging modality highly effective in detecting scaphoid fractures,
enabling early adequate treatment,
and omitting the need of unnecessary immobilization in patients without fracture.
it may demonstrate concomitant fractures notoriously difficult to see on radiographs.
De Silva GL,
Imaging and treatment of scaphoid fractures and their complications.
Semin Musculoskelet Radiol 2012;16:159-174
Le diagnosticdes fractures récentes du scaphoïde : revue de la littérature.(The diagnosis of recent scaphoid fractures: review of the literature).
J Radiol 2007;88:741-759
De Vos W,
Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a...