The incidence of surgical intervention following a suspected scaphoid fracture

Paul Ryan, Andrew Duckworth, Jane E McEachan, Paul Jenkins

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Aims: The underlying natural history of suspected scaphoid fractures (SSF) is unclear and assumed poor. There is an urgent requirement to develop the literature around SSFs to quantify the actual prevalence of intervention following SSF. Defining the risk of intervention following SSF may influence the need for widespread surveillance and screening of SSF injuries and could potentially influence medicolegal actions around missed scaphoid fractures.

Methods: Data on SSF was retrospectively gathered from Virtual Fracture Clinic (VFC) across a large Scottish Health Board over a four-year period from 1st January 2018 – 31st December 2021. The Bluespier Electronic Patient Record System identified any surgical procedure being undertaken in relation to a scaphoid injury over the same time period. Isolating patients who underwent surgical intervention for SSF was performed by cross referencing the unique patient Community Health Index [CHI] number for patients who underwent these scaphoid procedures with those seen at VFC for SSF over this four-year period.

Results: 1739 patients were identified as having had a SSF. Five patients (0.28%) underwent early ORIF. One patient (0.06%) developed a non-union and underwent ORIF with bone grafting. All 6 patients undergoing surgery were male (p=0.0055). The overall rate of intervention following a SSF was 0.35%. The early intervention rate in those undergoing primary MRI was one (0.36%) compared with 3 in those without (0.27%)(p>0.576, Fishers exact test).

Conclusions: Surgical intervention was rare following a SSF and was not required in women. A primary MRI policy did not appear be associated with any change in primary or secondary intervention. This data is the first and largest in recent literature to quantify the prevalence of surgical intervention following a SSF and may be used to guide surveillance and screening pathways as well as defining medicolegal risk involved in missing a true fracture in SSFs.
Original languageEnglish
Pages (from-to)312 - 316
Number of pages5
JournalBone & Joint Open
Volume5
Issue number4
DOIs
Publication statusPublished - 17 Apr 2024

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