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. 2025 Mar 3;6(3):246-253.
doi: 10.1302/2633-1462.63.BJO-2024-0211.R1.

The diagnostic characteristics and reliability of radiological methods used in the assessment of scaphoid fracture union : a systematic review

Gemma Smith  1 , Wai H Teng  2 , Nicholas D Riley  2 , Christopher Little  2 , Edward Sellon  2 , Neal Thurley  3 , Joe Dias  4 , Benjamin J F Dean  5   2
Affiliations

The diagnostic characteristics and reliability of radiological methods used in the assessment of scaphoid fracture union : a systematic review

Gemma Smith et al. Bone Jt Open. .

Abstract

Aims: To evaluate the diagnostic characteristics and reliability of radiological methods used to assess scaphoid fracture union through a systematic review and meta-analysis.

Methods: MEDLINE, Embase, and the Cochrane Library were searched from inception to June 2022. Any study reporting data on the diagnostic characteristics and/or the reliability of radiological methods assessing scaphoid union was included. Data were extracted and checked for accuracy and completeness by pairs of reviewers. Methodological quality was assessed using the QUADAS-2 tool.

Results: A total of 13 studies were included, which were three assessed radiographs alone, six CT alone, and four radiographs + CT. Diagnostic sensitivity was assessed by CT in three studies (0.78, 0.78, and 0.73) and by radiographs in two studies (0.65, 0.75). Diagnostic specificity was assessed by CT in three studies (0.96, 0.8, 0.4) and by radiographs in two studies (0.67, 0.4). Interobserver reliability was assessed for radiographs by seven studies (two fair, four moderate, and one substantial) and for CT in nine studies (one fair, one moderate, six substantial, and one almost perfect).

Conclusion: There is evidence to support both the use of CT and radiographs in assessing scaphoid fracture union. Although CT appears superior in terms of both its diagnostic characteristics and reliability, further research is necessary to better define the optimal clinical pathways for patients.

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Conflict of interest statement

B. J. F. Dean reports an Orthopaedic Research UK grant, which is unrelated to this work. J. Dias discloses an unrelated SWIFFT NIHR grant. N. D. Riley declares consulting fees from Acumed, Arthrex, and Sovereign Medical; and being on the orthopaedic data evaluation hand and wrist panel, all of which are also unrelated.

Figures

Fig. 1
Fig. 1
Study selection process.
See this image and copyright information in PMC

References

    1. Leslie IJ, Dickson RA. The fractured carpal scaphoid. Natural history and factors influencing outcome. J Bone Joint Surg Br. 1981;63-B(2):225–230. doi: 10.1302/0301-620X.63B2.7217146. - DOI - PubMed
    1. Shenoy R, Pillai A, Hadidi M. Scaphoid fractures: variation in radiographic views - a survey of current practice in the West of Scotland region. Eur J Emerg Med. 2007;14(1):2–5. doi: 10.1097/01.mej.0000228445.63523.b7. - DOI - PubMed
    1. Yin ZG, Zhang JB, Kan SL, Wang XG. Diagnosing suspected scaphoid fractures: a systematic review and meta-analysis. Clin Orthop Relat Res. 2010;468(3):723–734. doi: 10.1007/s11999-009-1081-6. - DOI - PMC - PubMed
    1. Dias JJ, Kheiran A, Ngo DN, et al. The onset, progress and factors influencing degenerative arthritis of the wrist following scaphoid fracture non-union. Injury. 2023;54(3):930–939. doi: 10.1016/j.injury.2022.12.025. - DOI - PubMed
    1. Farracho LC, Moutinot B, Neroladaki A, et al. Determining diagnosis of scaphoid healing: comparison of cone beam CT and X-ray after six weeks of immobilization. Eur J Radiol Open. 2020;7:100251. doi: 10.1016/j.ejro.2020.100251. - DOI - PMC - PubMed

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