The Evaluation of Scaphoid Fractures by Coronal Computed Tomography

Abstract

Introduction: Since most of the scaphoid fractures are parallel to the transverse plane, it is difficult to evaluate these fractures by standard axial computed tomographies (CT). That is why we need to investigate these fractures in a plane perpendicular to the fracture line. This study was conducted in an attempt to evaluate the value of the coronal CT in scaphoid fractures. Materials and
Methods: In this study 18 patients (2 female, 16 male) between the ages of 18 and 42, in whom we thought scaphoid fracture by physical examination with normal or suspected radiographs were evaluated. Standard axial CT was performed initially and then coronal sections were taken by giving special position to the hand without any special equipment. The same CT parameters were used in these two examinations.
Results: Both coronal and axial CT sections were performed successfully in all of the patients (94 %) except one in whom the coronal sections could not be performed because of the pain in desired position. In 2 patients both examinations were normal. In all the remaining 15 patients (100 %) the fracture line could be seen by coronal sections whereas the fractures could be seen in standard axial sections in only 10 patients (67 %).
Discussion: CT is the gold standard for evaluation of the fractures if the appropriate sections are taken. When it is considered that most of the scaphoid fractures are parallel to the transverse plain, other sections rather than standard axial ones seems necessary. It is concluded that coronal CT sections give more accurate information compared to standard axial sections particularly in occult scaphoid fractures.