Is intrasound vibration useful in the diagnosis of occult scaphoid fractures?

This study was designed to confirm the results of Finkenberg et al. (J Hand Surg 1993;18A: 4-7), who found a high sensitivity (100%) and specificity (95%) of the intrasound vibration method in diagnosing occult scaphoid fractures. These occult scaphoid fractures are not visible on x-ray films, but clinically the patients are suspected of having a scaphoid fracture.

The value of additional carpal box radiographs in suspected scaphoid fracture.

Rationale And Objectives: Carpal Box (CB) radiographs, transverse and longitudinal, produce elongated and magnified views of the carpus. These radiographs can be used after carpal injury, in addition to conventional scaphoid x-rays. In this study, the use of CB radiographs was evaluated in patients with possible scaphoid fracture.

Randomised controlled trial of single-dose antibiotic prophylaxis in surgical treatment of closed fractures: the Dutch Trauma Trial.

Background: The efficacy of prophylactic antibiotics in fracture surgery remains controversial for lack of well-documented prospective studies. We report here the findings of the Dutch Trauma Trial, a prospective, randomised, double-blind, placebo-controlled study of antibiotic prophylaxis in the primary operative treatment of limb fractures. Ceftriaxone was chosen because of its pharmacokinetic profile, including high serum levels, high tissue penetration, and long elimination half-life, makes it suitable for single-dose prophylaxis.

Choosing a strategy for the diagnostic management of suspected scaphoid fracture: a cost-effectiveness analysis.

Unlabelled: To assess the cost-effectiveness of various strategies for the diagnostic management of clinically suspected scaphoid fracture, a decision-analytic model was built to evaluate three strategies and to compare them with a (clairvoyant) reference diagnostic management strategy.

Methods: Evaluated strategies were: (A) repeated radiography up to 2 wk; (B) repeat radiography up to 6 wk; and (C) radiography, followed by bone scintigraphy in patients with negative initial radiographs. Therapy consisted of 12 wk of immobilization for a radiographically or scintigraphically proven fracture.

Significance of a hot spot on the bone scan after carpal injury--evaluation by computed tomography.

The use of bone scintigraphy in patients with negative radiographs after carpal injury is widely advocated. However, focally increased activity on the bone scan in the scaphoid or other carpal bones cannot always be radiologically confirmed as a fracture. To confirm scintigraphically suspected carpal fractures, computed tomography (CT) of the wrist was performed in patients with clinically suspected scaphoid fracture and initially negative radiographs.

Radiography of the carpal scaphoid. Experimental evaluation of "the carpal box" and first clinical results.

Rationale And Objectives: The authors describe a new device ("the carpal box") for the radiographic detection of occult scaphoid fracture.

Methods: Fractures in the scaphoid of five cadaver specimens were mechanically produced. Subsequent examinations included conventional scaphoid radiography, multi-angle radiography, and radiography using the new device.