Occult Scaphoid Fractures: A Multi-Centre Service Evaluation of MRI Practice
Background
Why this project was needed
Occult scaphoid fractures — those not visible on initial plain radiographs but subsequently detected on MRI — represent a clinically important diagnostic challenge. Missed or delayed diagnosis can result in avascular necrosis and non-union, with significant long-term morbidity. This multi-centre evaluation assessed the rate of complications and subsequent surgical intervention in patients with occult scaphoid fractures identified via MRI at GSTT and collaborating centres.
Aims
What the project set out to achieve
To assess the complications arising from occult scaphoid fractures detected by early MRI at GSTT, and to evaluate the outcomes of this diagnostic approach across collaborating centres.
Objectives
Specific measurable steps
- Retrospectively identify all patients who underwent wrist MRI following a normal scaphoid series between January and December 2022.
- Document the proportion in whom an occult scaphoid fracture was confirmed on MRI.
- Record rates of avascular necrosis, non-union and requirement for operative intervention.
- Compare complication rates against published literature benchmarks.
Discussion
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