X-ray diagnosis of acute scaphoid fractures

In a retrospective review of the radiographs taken for 113 acute scaphoid fractures, each view was assessed for the clarity of demonstration of the fracture. The X-rays on which diagnosis of fracture were made, were taken between 0 and 16 days after injury (mean, 2 days). Whenever a lateral, supinated oblique or elongated view was taken, the fracture was always seen clearly on an alternative view. We recommend the use of four views at initial presentation of suspected scaphoid fracture: PA and lateral to assess carpal alignment, with pronated oblique and ulnar deviated PA to detect the fracture.