Trapezium fracture: a common clinical mimic of scaphoid fracture

Gibney, Brian; Murphy, Mark C.; Ahern, Daniel P; Hynes, D. M.; MacMahon, Peter

doi:10.1007/s10140-019-01702-2

Cited by 9 publications

(9 citation statements)

References 38 publications

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“…The title and abstract screen of the 43 results produced nine papers. Two papers used the same data; the paper which focused on scaphoid fracture was included [12,23]. One paper did not distinguish between the results of upper and lower limb fractures and was therefore excluded [24].…”

Section: Results Of Searchmentioning

confidence: 99%

The use of cone-beam computed tomography (CBCT) in radiocarpal fractures: a diagnostic test accuracy meta-analysis

et al. 2021

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Objective Occult radiocarpal fractures often present a diagnostic challenge to the emergency department. Accurate diagnosis of these injuries is crucial as a missed fracture can lead to significant morbidity. Cone-beam CT (CBCT) scan is a novel imaging modality, with minimal radiation exposure and comparatively fast acquisition time. Our aim was to evaluate its use in the diagnosis of cortical fractures in the upper limb extremity. Materials and methods We conducted a systematic review of literature and included all studies that evaluated the use of CBCT in the diagnosis of radiocarpal fractures. We used a mixed-effects logistic regression bivariate model to estimate the summary sensitivity and specificity and constructed hierarchical summary receiver operative characteristic curves (HSROC). Results We identified 5 studies, with 439 patients, and observed CBCT to be 87.7% (95% CI 77.6–93.6) sensitive and 99.2% (95% CI 92.6–99.9) specific for scaphoid fractures. For carpal fractures, CBCT was observed to have a pooled sensitivity and specificity of 90.6% (95% CI 72.7–97.2) and 100% (95% CI 99–100) respectively. For distal radius fractures, CBCT sensitivity was 90% (95% CI 67–98) and specificity was 100% (95% CI 10–100). The overall inter-rater agreement effect was shown to be 0.89 (95% CI 0.82–0.96), which is deemed to be almost perfect. Conclusion CBCT is an accurate diagnostic tool for occult radiocarpal cortical fractures, which could replace or supplement radiographs. We believe CBCT has a promising role in the acute radiocarpal fracture diagnostic algorithm in both emergency and trauma departments.

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Section: Results Of Searchmentioning

confidence: 99%

The use of cone-beam computed tomography (CBCT) in radiocarpal fractures: a diagnostic test accuracy meta-analysis

et al. 2021

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“…Fractures of the trapezium, trapezoid and the lunate seem to be far more common than previously recognized. Gibney et al (2019) stated, in their CBCT study of patients with wrist pain and normal radiographs, that the trapezium is the most common radiographically occult radiocarpal fracture. Lunate fractures are described in the literature as rare, comprising 0.5-1% of all carpal fractures and when they are found, they are usually part of a more complex fracture pattern with concomitant fractures, of other carpal bones or the distal radius, and ligament injuries leading to midcarpal instability (Shunmugam et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Fractures of the trapezium, trapezoid and the lunate seem to be far more common than previously recognized. Gibney et al. (2019) stated, in their CBCT study of patients with wrist pain and normal radiographs, that the trapezium is the most common radiographically occult radiocarpal fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Multidetector computed tomography (MDCT) has proven superior to conventional radiography in fracture detection but the high radiation dose limits its routine use ( De Smet et al., 2015 ). Cone-beam computed tomography (CBCT) is an imaging technique generating a higher spatial resolution at a lower radiation dose than MDCT ( De Smet et al., 2015 ) and has shown to be more accurate than conventional radiography for the diagnosis of fractures of the carpal bones ( De Smet et al., 2015 ; Gibney et al., 2019 ; Neubauer et al., 2018 ). The effective radiation dose of CBCT is only 0.7–2.4 times higher than conventional radiography ( Koivisto et al., 2018 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cone-beam computed tomography for primary investigation of wrist trauma provides a new map of fractures of carpal bones

Krayem

Lensing

Fornander

2021

J Hand Surg Eur Vol

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In 2016, our primary modality for radiological examination of wrist trauma, was changed from radiography to cone-beam computed tomography (CBCT). This is a retrospective survey of carpal bone fractures detected by CBCT during 6 months in 2016/2017, compared with those found on conventional radiographs during 6 months in 2013/2014. The incidence of carpal fractures was three times higher during the CBCT period (92/100,000 per year) compared with the radiography period (29/100,000 per year) and the spectrum of anatomical locations was different between the two periods, with fractures of the lunate ( n = 6), trapezium ( n = 9), trapezoid ( n = 4) and capitate ( n = 1) detected by CBCT, in contrast to no fractures of these bones diagnosed during the 6 months radiography period. We suggest a more liberal use of CBCT for examination of wrist trauma considering the benefits of being able to give patients a correct primary diagnosis, treatment and prognosis. Level of evidence: III

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“…Use of cone-beam CT in evaluation of patients with suspected radiographically occult fractures has identified a high incidence of radiocarpal fractures, many of which are avulsion-type injuries (3). In particular, fractures of the volar ridge of the trapezium were found to be the most common radiographically occult carpal bone fracture at cone-beam CT, followed by triquetrum and scaphoid fractures (4). Avulsion fractures of the tip of the trapezial ridge are thought to occur due to tension across the transverse carpal ligament caused by sudden widening of the carpal arch when load is applied to the palm by a patient experiencing a fall on an outstretched hand (5).…”

Section: Editormentioning

confidence: 99%