{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:02:34Z","timestamp":1777852954432,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,12,15]],"date-time":"2020-12-15T00:00:00Z","timestamp":1607990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hand Surg Eur Vol"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>\n                    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 (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009602) with a low clinical suspicion were discharged and 35% (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009320) 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 \u00a359,666.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Level of evidence:<\/jats:bold>\n                    III\n                  <\/jats:p>","DOI":"10.1177\/1753193420979465","type":"journal-article","created":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T01:36:00Z","timestamp":1608082560000},"page":"292-296","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Reliability of clinical tests for prediction of occult scaphoid fractures and cost benefit analysis of a dedicated scaphoid pathway"],"prefix":"10.1177","volume":"46","author":[{"given":"Preetham","family":"Kodumuri","sequence":"first","affiliation":[{"name":"Wrexham Maelor Hospital, Wales, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"McDonough","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Lyle","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaf","family":"Naqui","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Muir","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,12,15]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753193420909491"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2014.05.007"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2011.114157"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12317"},{"issue":"3","key":"e_1_3_3_6_1","first-page":"S9","article-title":"Management of suspected scaphoid fractures in 22 UK centres","volume":"43","author":"Davis TR","year":"2018","unstructured":"Davis TR, BSSH.. Suspected Scaphoid Fracture Group Management of suspected scaphoid fractures in 22 UK centres. J Hand Surg Eur. 2018, 43(3 suppl): S9.","journal-title":"J Hand Surg Eur"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.94B7.28704"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.98B5.36938"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1564983"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.05.009"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0000000000000152"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00099"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681_88_90058-7"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2014.06.004"},{"key":"e_1_3_3_15_1","doi-asserted-by":"crossref","unstructured":"Mallee WH Wang J Poolman RW et\u00a0al. Computed tomography versus magnetic resonance imaging versus bone scintigraphy for clinically suspected scaphoid fractures in patients with negative plain radiographs. Cochrane Database Syst Rev. 2015 CD010023.","DOI":"10.1002\/14651858.CD010023.pub2"},{"key":"e_1_3_3_16_1","unstructured":"NICE Guideline No. 38. Appendix M Cost-effectiveness analysis: imaging of suspected scaphoid fractures. 2016. https:\/\/www.nice.org.uk\/guidance\/ng38\/evidence\/full-guideline-2358460765 (accessed 26 November 2019)."},{"key":"e_1_3_3_17_1","first-page":"324","article-title":"Combining the clinical signs improves diagnosis of scaphoid fractures","volume":"23","author":"Parvizi J","year":"1998","unstructured":"Parvizi J, Wayman J, Kelly P, Moran CG. Combining the clinical signs improves diagnosis of scaphoid fractures. A prospective study with follow-up. J Hand Surg Br. 1998, 23: 324\u20137.","journal-title":"A prospective study with follow-up. 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Acta Orthop Belg. 2006, 72: 404\u201310.","journal-title":"Acta Orthop Belg"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(94)90249-6"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000316"}],"container-title":["Journal of Hand Surgery (European Volume)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1753193420979465","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1753193420979465","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1753193420979465","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:45:32Z","timestamp":1777502732000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1753193420979465"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,15]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1177\/1753193420979465"],"URL":"https:\/\/doi.org\/10.1177\/1753193420979465","relation":{},"ISSN":["1753-1934","2043-6289"],"issn-type":[{"value":"1753-1934","type":"print"},{"value":"2043-6289","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,15]]}}}