MRI in the management of scaphoid fractures in skeletally immature patients.
BACKGROUND: The scaphoid is the commonest fractured carpal bone, but excluding a scaphoid fracture with plain radiographs is difficult. Other imaging modalities are being increasingly evaluated in the management of scaphoid injuries. MRI has been shown to be of considerable value in the adult population but there have been limited studies of its use in children. PURPOSE: To evaluate the role of MRI in the acute management of suspected scaphoid injuries in children. METHODS AND MATERIALS: Fifty-six children (57 injuries) who had a suspected scaphoid injury underwent MRI within 10 days of their initial trauma. The results of MRI were used to dictate management of the injury. RESULTS: In 33 (58%) of the 57 injuries, MRI was normal and the patient was discharged from care. In 16 cases (28%), a fractured scaphoid was diagnosed and appropriate treatment started early. Additionally, other fractures around the wrist joint and ganglion cysts were demonstrated on MRI. CONCLUSIONS: MRI of acute scaphoid injuries in children significantly alters management. Those children with normal scans are discharged earlier. Scaphoid fractures are confirmed earlier and other pathological conditions are also detected.