[Healing of scaphoid fractures assessed by tomography. A follow-up study of treated patients]

Thirty-five of 40 patients who had sustained an undisplaced fracture of the waist of the scaphoid were reviewed clinically and radiographically (including tomography) at a median of 70 (13-120) weeks after injury. All fractures had been retained in a below elbow scaphoid plaster for a period of median eight (3-12) weeks. End of treatment was based on the absence of "tenderness" over the scaphoid and on radiographical signs of fracture union median ten (5-24) weeks after injury. At review 28 (80%) of the fractures were united based on standard radiographs and tomography. Four fractures ((11%) 95% confidence limits: 3-27%) were nonunions and three fractures (9%) were probably united. Tomography gave additional information about the state of union if the fracture was visible but unclassifiable on standard radiographs. Tenderness over the scaphoid was only found in the nonunions and probably united fractures. Radiographic and clinical evaluation of the fracture six months after injury is recommended.