J Hand Microsurg 2018; 10(03): 130-133
DOI: 10.1055/s-0038-1636831
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Reliability of Diagnosis of Partial Union of Scaphoid Waist Fractures on Computed Tomography

Tessa Drijkoningen
1   Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, United States
,
Paul Willem Louis ten Berg
2   Department of Plastic Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
,
Thierry G. Guitton
3   Department of Plastic Surgery, University Medical Center Groningen, Groningen, The Netherlands
,
David Ring
4   Department of Comprehensive Care, The University of Texas at Austin, Dell Medical School, Austin, Texas, United States
,
Chaitanya S. Mudgal
5   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, United States
› Author Affiliations
Funding None.
Further Information

Publication History

Received: 19 November 2017

Accepted after revision: 20 January 2018

Publication Date:
20 March 2018 (online)

Abstract

Computed tomography (CT) is increasingly used not just to diagnose union but also to estimate the percentage of the fracture gap that is bridged by healing bone. This study tested the primary null hypothesis that there is no agreement between observers on the extent of union of a scaphoid waist fracture on CT. CT scans of 13 nondisplaced scaphoid waist fractures treated nonoperatively were rated by 145 observers. CT scans were done 10 to 12 weeks after injury. Observers were asked to “eyeball” measure percentage of union. We found that there was a moderate agreement on the categorical degree of partial union of a scaphoid waist fracture on CT (k = 0.34). Agreement on the location of bony bridging was slight (k = 0.31). We concluded that there is limited reliability of diagnosis of partial union of a scaphoid waist fracture on CT and that this should be taken into account in both patient care and research. This is a Level III, diagnostic study.

 
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