Beeres F J P, Hogervorst M, den Hollander P, Rhemrev S
Department of Traumatology, Medisch Centrum Haaglanden, The Hague, The Netherlands.
Injury. 2005 Oct;36(10):1233-6. doi: 10.1016/j.injury.2005.02.009. Epub 2005 Jun 24.
Undisplaced scaphoid fractures are easily missed on conventional scaphoid radiographs, but these occult fractures may seriously impair hand function. Routine bone scintigraphy (BS) is often advocated if there are clinical signs of a scaphoid fracture without radiological evidence. However, the results require careful therapeutic management.
To determine the diagnostic value of BS in daily practice for clinically suspected scaphoid fractures.
We evaluated our protocol of routine BS in suspected scaphoid fractures.
In a retrospective study, we analysed 111 consecutive cases with signs of a scaphoid fracture on physical examination. Radiographs revealed 55 fractures, the remaining 56 patients all underwent BS.
On average, the BS was performed after 4 days. It showed a fracture in 38/56 of the patients. The distribution of fractures was: scaphoid bone 15, distal radius 11, other carpal bones 9 and metacarpal bones 3.
If there is a strong clinical suspicion of a scaphoid fracture, which cannot be confirmed by conventional radiology, BS is a valuable diagnostic tool.
无移位的舟骨骨折在传统舟骨X线片上很容易被漏诊，但这些隐匿性骨折可能会严重损害手部功能。如果存在舟骨骨折的临床体征而无放射学证据，通常提倡进行常规骨闪烁显像（BS）检查。然而，检查结果需要谨慎的治疗管理。
确定在日常实践中BS对临床疑似舟骨骨折的诊断价值。
我们评估了疑似舟骨骨折时常规BS检查方案。
在一项回顾性研究中，我们分析了111例体格检查有舟骨骨折体征的连续病例。X线片显示55例骨折，其余56例患者均接受了BS检查。
平均而言，BS检查在4天后进行。结果显示56例患者中有38例存在骨折。骨折分布情况为：舟骨15例，桡骨远端11例，其他腕骨9例，掌骨3例。
如果临床高度怀疑舟骨骨折而传统放射学检查无法确诊，BS是一种有价值的诊断工具。
