Treatment for scaphoid fracture is based on the site of the fracture i.e. Sometimes, an MRI scan, CT scan or bone scan can also be ordered to confirm the diagnosis of the scaphoid fracture. Your doctor will also advise you to use a splint and avoid lifting anything heavy for a few weeks and then order another X-ray to check for visibility of the fracture.
Hence, your doctor will test for tenderness at the site of the scaphoid bone to detect the fracture. Scaphoid fractures are diagnosed by X-rays however, a non-displaced fracture does not show up on an X-ray when it is taken as early as the first week. There are chances that the patient might not be aware of the fracture for months or even years after the fall as the pain generally improves in a few days. Bruising is also a very rare symptom of the fracture. There is usually no deformity at the site of fracture, hence it may be mistaken for just a sprain. Symptoms of a scaphoid fracture include pain and swelling at the site of injury (base of the thumb and forearm). This fracture usually occurs during motor accidents or sports activities. Scaphoid fracture occurs due to a fall on an outstretched hand with complete weight falling on the palm. They can occur at two places: near the thumb or near the forearm.
A scaphoid fracture is usually seen in young men aged 20 to 30 years. It is present on the thumb side of the wrist causing it to be at a high risk for fractures. Published by Elsevier Ltd.The scaphoid bone is a small, boat-shaped bone in the wrist, which, along with 7 other bones, forms the wrist joint. Improved awareness through better education is required to reduce the number of missed scaphoid fractures.įracture MRI Missed Negligence Scaphoid.Ĭopyright © 2019. As a scaphoid fracture was never considered, or excluded by clinical examination, in 49 of the 52 cases, a policy of obtaining MRI for all suspected scaphoid fractures would only have detected three of 52 (6%) fractures. Some were missed due to failure to detect (or absence of) tenderness over the scaphoid bone. Most of these scaphoid fractures were missed due to failure to consider the possibility of a scaphoid fracture and search for clinical signs of this injury. In only 5 (10%) cases was there a record of the patient being advised to return if the wrist remained painful.
Scaphoid pain but no fracture series#
No X-rays were obtained in 13 (25%) cases, and a scaphoid fracture was only suspected, resulting in scaphoid series X-rays being performed, in only 3 (6%) cases. Scaphoid tenderness was assessed and not found in 10 of 15 cases. There was no record of an examination for scaphoid tenderness in 37 (71%) cases.
The recorded mechanism of injury was consistent with a scaphoid fracture in 41 (79%) cases. Complete sets of hospital and GP records and X-rays had been reviewed in every case. Medical reports on 52 medical negligence cases of missed scaphoid fractures were reviewed. It also assesses how many might have been detected if MRI had been used to assess all suspected scaphoid fractures with normal X-rays, as suggested by National Institute for Health and Care Excellence (NICE). This study investigates why a series of scaphoid fractures involved in medical negligence litigation were missed. The "missed" scaphoid fracture is a common cause of litigation.
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