Abstract
Objective
Delayed radiographs are routinely done to help in diagnosis of occult scaphoid fractures. Our aim was to determine the diagnostic value of these late x-rays.
Methods
This is a radio-diagnostic study. We prospectively reviewed radiographs of 67 patients with injury to their wrists who presented with anatomical snuff box to the accident and emergency department.5 patients showed up a fracture of the scaphoid on trauma x-rays and they were excluded from the study. All patients had a radiograph on day of presentation as well as a delayed radiograph at a later date. The radiographs were standardized to include 4 scaphoid views. All the radiographs were reported independently by a consultant radiologist (JN) and a consultant orthopaedic surgeon (ML).
Results
62 radiographs of 42 males and 20 females with an average age of 25.91 were examined. The two sequential radiographs were taken at an average delay of 10.23 days. There was no difference of opinion between the radiologist and the orthopaedic surgeon with regards to reporting. Only one of the late radiographs showed up a fracture of the proximal pole. Rest of the x-rays failed to detect any bony injury.
Conclusion
If a fracture is not visible on first day it is difficult to visualize the fracture in delayed x-rays and a strong clinical suspicion should be supplemented with a more specific investigation like a bone scan or MRI scan. We present our data with an up to date review of literature.
