Risk reduction through skeletal scintigraphy as a screening tool in suspected scaphoid fracture: a literature review

Fractures of the scaphoid are the most common carpal injuries. Suspected scaphoid injuries make up a large part of the work of an accident and emergency department, and unfortunately make up a significant percentage of litigation claims. Initial radiographs cannot always detect fractures while undisplaced and subsequently untreated fractures may give rise to premature carpal collapse and degenerative arthritis with alterations in the kinematics of the wrist. The use of scintigraphy in the diagnosis of fractures of the carpal scaphoid has been used routinely as a valuable supplementary examination. It has been shown to be more sensitive than routine radiography and it has been suggested that the results of early bone scanning should guide the treatment of patients with suspected scaphoid fractures. This literature review aims to look at the various studies performed regarding the use of bone scanning in suspected scaphoid fractures and an attempt to formulate a management protocol is made.