Management of Scaphoid Injuries and role of early Advanced Imaging for Urgent care clinics in New Zealand.

Author: Dr Muhammad Asim
Type: MLP-case study
Date: 26 December 2017
Abstract: The Scaphoid is the most commonly injured bone amongst carpal bones at the wrist. It accounts for 10% of all hand fractures, 50-80% of all carpal fractures and is one of the most common injuries seen by doctors working in Urgent care clinics. Risk of non-union is up to 10% in all non-displaced fractures. There are serious consequences such as non-union, avascular necrosis and arthritis if this fracture is missed during the initial evaluation. When a high index of suspicion based on the mechanism of injury and clinical exam exists the current protocol is for immobilization with delayed (10+ days) x-rays. Is another imaging strategy more sensitive and cost effective?