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Detecting Fractures of the Scaphoid: the Value of Comparative X-rays of the Uninjured Wrist

From the Department of Orthopaedics, Huddersfield Royal Infirmary

Correspondence: Mr John Cleary, M.Ch(Orth.), F.R.C.S., Consultant Orthopaedic Surgeon, Huddersfield Royal Infirmary, Huddersfield HD3 3EA.

Pain or tenderness in the anatomical snuff-box following trauma suggests an injury to the scaphoid or surrounding soft tissues. It is often difficult to make a definite diagnosis since normal bone markings across the scaphoid can be misinterpreted as a fracture. To clarify whether a fracture is present or not, an X-ray of the uninjured scaphoid is taken in a comparable position to the most suspicious view. If bone markings are similar on both views, then a fracture can be excluded. Conversely, if the bone markings differ, then suspicion of a fracture may be confirmed. In combination with the clinical features, a more accurate diagnosis can be made and unnecessary out-patient and X-ray reviews can be avoided.

Journal of Hand Surgery (British and European Volume), Vol. 17, No. 1, 28-32 (1992)
DOI: 10.1016/0266-7681(92)90008-P


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