High-resolution CT of the wrist: initial experience with scaphoid disorders and surgical fusions

We performed high-resolution CT scans on 30 wrists in 27 patients with either previous surgical intercarpal fusion or known or suspected scaphoid abnormalities. Most examinations used the same protocol: contiguous 1.5-mm axial sections parallel to the long axis of the body of the scaphoid, small reconstruction circle, and bone reconstruction algorithm. Fifteen patients were evaluated for union of previous surgical carpal fusions; eight patients were evaluated for healing of scaphoid fractures; and the other four patients had miscellaneous disorders, including a midcarpal dislocation with a scaphoid fracture. High-resolution CT clearly showed whether the carpal fusions were united. In addition, metallic fixation devices were easy to locate and did not significantly degrade image quality. Osseous union of healing scaphoid fractures was reliably assessed. We conclude that high-resolution CT of the wrist is a useful method for evaluating surgical carpal fusions and various disorders of the scaphoid.