Wrexham Maelor Hospital, Wales, UK.
Salford Royal NHS Foundation Trust, Salford UK.
J Hand Surg Eur Vol. 2021 Mar;46(3):292-296. doi: 10.1177/1753193420979465. Epub 2020 Dec 15.
We reviewed the outcomes of our dedicated clinic for suspected scaphoid fractures. The primary outcome measure was to test the reliability of accurately diagnosing an occult scaphoid fracture with a combination of anatomical snuff box, scaphoid tubercle, longitudinal compression tenderness, ulnar deviation and the pinch test. Cost savings of the new patient pathway was our secondary outcome measure. Between December 2016 and March 2020, 922 patients were recruited at a mean of 12 days post-injury. Sixty-five per cent ( = 602) with a low clinical suspicion were discharged and 35% ( = 320) with a high clinical suspicion had same day MRI scan. Fifty-eight scaphoid fractures were diagnosed and treated with no nonunions reported. Anatomical snuff box tenderness was the most sensitive test (90%). A combination of five tests better excluded an occult fracture (80% accuracy). The dedicated scaphoid clinic pathway resulted in 350 fewer follow-up visits and an overall saving of £59,666. III.
我们回顾了专门的舟状骨疑似骨折诊所的治疗结果。主要的疗效指标是测试结合解剖鼻烟窝、舟状骨结节、纵向压缩压痛、尺偏和捏压试验准确诊断隐匿性舟状骨骨折的可靠性。新患者通路的成本节约是我们的次要疗效指标。在 2016 年 12 月至 2020 年 3 月期间，922 名患者在受伤后平均 12 天入组。65%（=602）临床怀疑度低的患者被出院，35%（=320）临床怀疑度高的患者当天进行 MRI 扫描。诊断出 58 例舟状骨骨折并进行治疗，无骨不连报告。解剖鼻烟窝压痛是最敏感的测试（90%）。五项测试的结合更好地排除了隐匿性骨折（80%的准确性）。专门的舟状骨诊所通路减少了 350 次随访，总体节省了 59666 英镑。III。
