Evidence map›Paper›PMID 34182789›Full record

ArticleBone & joint open2021

Suspected scaphoid injuries managed by MRI direct from the emergency department : a single-centre prospective cohort study.

Benjamin J F Dean, Christopher Little, Nicholas D Riley, Edward Sellon, Warren Sheehan, Jenna Burford, Phil Hormbrey, Matthew L Costa

Open access · goldAbstract read
In one paragraph

Article in Bone & joint open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Benjamin J F DeanNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-8969-8868
Christopher LittleDepartment of Orthopaedics, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK.
Nicholas D RileyDepartment of Orthopaedics, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK.
Edward SellonDepartment of Orthopaedics, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK.
Warren SheehanDepartment of Orthopaedics, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK.
Jenna BurfordDepartment of Orthopaedics, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK.
Phil HormbreyDepartment of Orthopaedics, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK.
Matthew L CostaNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Nuffield Orthopaedic Centre · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo determine the role of early MRI in the management of suspected scaphoid fractures.

methodsA total of 337 consecutive patients presenting to an emergency department (ED) following wrist trauma over a 12-month period were prospectively included in this service evaluation project. MRI was not required in 62 patients with clear diagnoses, and 17 patients were not managed as per pathway, leaving a total of 258 patients with normal scaphoid series radiographs who were then referred directly from ED for an acute wrist MRI scan. Patient demographics, clinical details, outcomes, and complications were recorded at a minimum of a year following injury.

resultsThe median time from injury to ED presentation was one day and the median number of positive clinical signs was two out of three (snuffbox tenderness, tubercle tenderness, pain on telescoping). Of 258 patients referred for acute MRI, 208 scans were performed as 50 patients either did not tolerate (five patients) or did not attend their scan (45 patients). MRI scans demonstrated scaphoid fracture (13%), fracture of another bone (22%), scaphoid contusion (6%), other contusion/ligamentous injury (20%), or solely degenerative pathology (10%). Only 29% of scans showed no abnormality. Almost 50% of those undergoing MRI (100 patients) were discharged by ED with advice, with only one re-presentation. Of the 27 undisplaced occult scaphoid fractures, despite prompt cast immobilization, two experienced delayed union which was successfully treated with surgery.

conclusionThe use of MRI direct from ED enables prompt diagnosis and the early discharge of a large proportion of patients with normal radiographs following wrist trauma. Cite this article:

Indexed as

FractureMRIOutcomeScaphoidTraumaWrist

Identifiers

PMID34182789
PMCPMC8244792
OpenAlexW3176396137

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.