Scaphoid xray

Radiographic diagnosis for scaphoid fractures Huỳnh thị Linh Thu, MD Upper Limb Surgery Department Hospital for Traumatology & Orthopaedics Introduction The most commonly fractured carpal bone  Incidence: 2nd only to the distal radius  Most scaphoid fractures can be detected on radiographs at first presentation  anatomy  Scaphoid lies at 450 flexion and 200 radial deviation to long axis of the wrist Special projections needed to align the beam with the plane of fracture line  Wrist in neutral position Wrist in extension scaphoid views Ulnar deviation views  Schreck I views  Stecher views  Schreck II views  Ziter views  Larsen views  scaphoid views ULNAR DEVIATION VIEWS  The hand flat, finger in extension  wrist in ulnar deviation scaphoid views STECHER VIEWS Wrist in 20° extension, in 900 pronation  Ulnar deviation  scaphoid views SCHRECK II VIEWS Thumb and index in writing position  Wrist wrist on ulnar side, in 45° pronation  Case report case    Nguyen Hai S – male - 21 y/o - laborer 540CT/06 7th Feb 2006 : banging left wrist on a machine HTO Emergency : perilunate dislocation of left wrist  splint–> Upper Limb Surgery Department X ray at admission At emergency case  Upper   Limb Surgery Department: Pain on the radial side of the wrist Scaphoid views (schreck I, schreck II, unar deviation) taken on 9-2-06 detected scaphoid fracture Scaphoid views (9 - -06) (Scaphoid waist fracture) - month post op Case    Nguyen Trung T- male-21 y/o - fall from motocycle, hand in dorsiflexion (4 - - 06) HTO emergency (4 - - 06) : Trauma of right wrist: Immobilization with plaster splint 1st Follow-up (10 days after trauma): Keeping the splint Case  X ray on March 2006 no bone lesion detected Case  2nd    follow-up (16 days after trauma): Tenderness over the anatomic snuff box Increasing pain when moving the right wrist X ray (scaphoid views): scaphoid waist fracture X ray ( scaphoid views) on 20 - – 06 (16 days after trauma) Case   Le Anh D.- male-18 y/o – Cao Lanh Dong Thap- fall from motorcycle, hand in dorsiflexion months before provincial hospital: Wrist Trauma  : pain killer + splint  persistent pain in anatomic snuffbox  CT scan  HTO Case Case Conclusion Most scaphoid fractures can be detected in scaphoid views  Xrays: available, cheap, good for scaphoid fracture diagnosis  If suspecting of scaphoid fracture  long arm thumb spica cast in weeks  taking scaphoid views again  Watson-Jones: In the presence of tenderness over the anatomic snuffbox without deformity, a fracture of the scaphoid should always be presumed until radiographic examination proves negative beyond doubt Thank you ... HTO Case Case Conclusion Most scaphoid fractures can be detected in scaphoid views  Xrays: available, cheap, good for scaphoid fracture diagnosis  If suspecting of scaphoid fracture  long arm... Pain on the radial side of the wrist Scaphoid views (schreck I, schreck II, unar deviation) taken on 9-2-06 detected scaphoid fracture Scaphoid views (9 - -06) (Scaphoid waist fracture) - month post... the anatomic snuff box Increasing pain when moving the right wrist X ray (scaphoid views): scaphoid waist fracture X ray ( scaphoid views) on 20 - – 06 (16 days after trauma) Case   Le Anh D.-