Trauma, Technology assessment, Computer Applications-3D, CT-High Resolution, CT, Musculoskeletal system, Musculoskeletal bone, Extremities
L. H. L. De Beuckeleer, K. Carpentier, B. De Foer, M. Pouillon; Antwerp/BE
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 by a process of non-union with instability,
and late osteoarthritis,
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 a high economic cost.
Cone beam Computed Tomography (CBCT) has been widely adopted for dental 3D-imaging since the late 1990s .
Compared with multi-detector computed tomography (MDCT) imaging,
CBCT offers higher resolution with a relatively low radiation dose.
Besides use in dental and ORL applications on the first commercially available CBCT systems,
modern CBCT units afford examinations in seated or lying position,
therefore permitting high-resolution CBCT imaging of other body parts,
such as the wrist,
foot or ankle [4,5,6].
We investigated the potential role of low-dose cone-beam CT in the assessment of patients who sustained a trauma clinically suspicious for scaphoid fracture.
we examined whether CBCT potentially could identify supposedly occult scaphoid fractures,
thereby enabling accurate treatment for fractures at risk for osteonecrosis (proximal pole fractures) or for nonunion on the one hand,
and avoiding overtreatment in cases who definitely did not sustain a fracture on the other hand.