The role of bone scans in the assessment of prognosis of scaphoid fractures.

Fifty patients with radiographic evidence of an acute scaphoid fracture were studied prospectively. Technetium bone scans were performed on all patients soon after injury in an attempt to detect fractures at risk of non-union or avascular necrosis. In three patients the scan showed a focal area of decreased radionuclide concentration in the region of the proximal pole of scaphoid implying avascularity, and each developed the radiographic signs of avascular necrosis. Two of these patients, each with a displaced fracture, developed non-union. Acute fractures of the scaphoid with evidence of avascularity on bone scan are at high risk of developing non-union.