Scaphoid fracture
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My name is Jaycen Cruickshank I am an Emergency Physician in Ballarat, Victoria

I was the Director of ED for about 12 years, and am now the Director of Clinical Training and Supervisor of Intern Training at Ballarat Health Services. I am passionate about providing a positive learning experience for our junior medical staff and medical students

We have conducted the following research on scaphoid fractures at our insitition

  • Early CT in diagnosis of suspected scaphoid fracture
  • Early CT in a CPG in diagnosis of scaphoid fracture
  • Interobserver reliability of CT in Scaphoid and nearby fractures
  • Scaphoid fractures - WHere are they now? Compliance with guidelines 2008 vs 2012 in early

The shortest of summaries - if you suspect scaphoif fracture on clinical grounds and the initial XR is normal think 10/20/70
  • Expect fractures 10% scaphoid/ 20% nearby carpal or radius/ 70% no fracture
  • Early CT means early treatment plan and satisfied patients
  • MRI if available is also excellent
  • Use of guidelines is variable - your place should have one and people should use it
  • Interobserver reliability for sutble fractures is not perfect - clinical correlation and judgement is still important
We previously conducted this survey and sadly domaincentral as my host lost my entire website from 2007-2014. So we start again
If you suspect scaphoid fracture based on mechanism of injury, clinical signs including tenderness in anatomical snuff box, and have a normal initial XR, what strategy is recommended where you work, or what will you do?
Immobilize, repeat XR and examination in approx 10 days +/- further imaging D10
Early CT
Early MRI
Bone scan day 4
No further follow up

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