[Computerized tomography diagnosis of scaphoid fracture and pseudarthrosis in comparison with roentgen image]

Twenty eight patients with fourteen acute scaphoid fractures and fourteen with scaphoid non-union were examined with standard X-rays in two planes, special scaphoid projections and computed tomography. Nine scaphoid fractures were revealed by both standard X-rays and CT, whereas four fractures could only be detected by CT. Computed tomography should be used when there is clinical suspicion of scaphoid fracture but standard radiographs remain negative. All carpal bones should be examined. Fourteen patients with suspected scaphoid non-union were examined. In twelve patients, scaphoid non-union seemed to be complete in standard X-rays, whereas CT showed a bony bridge between the proximal and distal fragment. Another patient showed bony union. Two patients showed no non-union in standard X-rays. One was confirmed after a Matti-Russe procedure, but the bone graft was dislocated, causing restricted wrist motion. One scaphoid non-union was demonstrated by CT. Two patients showed signs of additional carpal fractures. Diagnostic applications of CT for scaphoid non-union include the determination of the exact location of the fragments and the evaluation of post-traumatic cysts, thus simplifying pre-operative planning.