{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:00:51Z","timestamp":1792825251045,"version":"4.5.0"},"reference-count":17,"publisher":"Royal College of Surgeons of England","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2008,9]]},"abstract":"INTRODUCTION<\/jats:title> Up to 40% of scaphoid fractures are missed at initial presentation as clinical examination and plain radiographs are poor at identifying scaphoid fractures immediately after the injury. Avoiding a delay in diagnosis is essential to prevent the risk of non-union and early wrist arthritis. We demonstrate the use of CT scanning for the early confirmation of a scaphoid fracture. <\/jats:p><\/jats:sec>PATIENTS AND METHODS<\/jats:title> We conducted a retrospective, chronological review of patients who attended an upper limb fracture clinic from January 2001 to October 2003 in a small district general hospital. We performed a CT scan on all \u2018clinical scaphoid\u2019 patients who had negative plain X-ray films. <\/jats:p><\/jats:sec>RESULTS<\/jats:title> Overall, 70% of patients had a CT scan within 1 week of injury and not from date of accident and emergency attendance; 83% of patients had a CT scan within 2 weeks of injury. Of 118 patients identified, 32% had positive findings and 22% of \u2018clinical scaphoid\u2019 patients had scaphoid fractures. The proportion of positive findings for an acute scaphoid fracture was 68%. Additional pathologies identified on CT were capitate, triquetral and radial fractures. <\/jats:p><\/jats:sec>CONCLUSIONS<\/jats:title> Our audit shows that it is practical to perform CT on suspicious scaphoid fractures in a small district general hospital. We identified an extremely high false-negative rate for plain X-rays and demonstrate that the appropriate use of CT at initial fracture clinic attendance with \u2018clinical scaphoid\u2019 leads to an earlier diagnosis and reduces the need for prolonged immobilisation and repeated clinical review. <\/jats:p><\/jats:sec>","DOI":"10.1308\/003588408x300948","type":"journal-article","created":{"date-parts":[[2008,8,30]],"date-time":"2008-08-30T21:53:54Z","timestamp":1220133234000},"page":"488-491","source":"Crossref","is-referenced-by-count":33,"title":["The Clinical Scaphoid Fracture: Early Computed Tomography as a Practical Approach"],"prefix":"10.1308","volume":"90","author":[{"given":"Q","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedics, Stafford Hospital Stafford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Stafford Hospital Stafford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Sloan","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Stafford Hospital Stafford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Bhoora","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Stafford Hospital Stafford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Willard","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Stafford Hospital Stafford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"171","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.3109\/17453679209154827"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(05)82039-6"},{"key":"b3","first-page":"755","volume-title":"Fractures in adult","author":"Cooney WP","year":"1996"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(94)90249-6"},{"key":"b5","first-page":"1257","volume":"177","author":"Dorsay TA","year":"2001","journal-title":"Am J Radiol"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.63B2.7217146"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.71B2.2925752"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(93)90173-D"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(92)90035-Q"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(93)90074-P"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0455.2003.00064.x"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.75B1.8421037"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.3109\/02841858809171221"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000124278.29127.42"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/19790905"},{"key":"b16","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1016\/S0749-0712(21)01454-2","volume":"17","author":"Plancher KD","year":"2001","journal-title":"Hand Clin"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(92)90118-L"}],"container-title":["The Annals of The Royal College of Surgeons of England"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/pdf\/10.1308\/003588408X300948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T09:59:12Z","timestamp":1684144752000},"score":1,"resource":{"primary":{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/10.1308\/003588408X300948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,9]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2008,9]]}},"alternative-id":["10.1308\/003588408X300948"],"URL":"https:\/\/doi.org\/10.1308\/003588408x300948","relation":{},"ISSN":["0035-8843","1478-7083"],"issn-type":[{"value":"0035-8843","type":"print"},{"value":"1478-7083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,9]]}}}