$The management of suspected scaphoid fractures in the UK: a national cross-sectional study$
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The management of suspected scaphoid fractures in the UK: a national cross-sectional study

Aims: Current National Institute for Health and Clinical Excellence (NICE) guidance advises that MRI direct from the emergency department (ED) should be considered for suspected scaphoid fractures. This study reports the current management of suspected scaphoid fractures in the UK and assesses adher...

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Autores principales:	Benjamin J. F. Dean, *On behalf of the SUSPECT study group
Formato:	article
Lenguaje:	EN
Publicado:	The British Editorial Society of Bone & Joint Surgery 2021
Materias:	scaphoid fracture pathway nice suspected wrist injury scaphoid fractures magnetic resonance imaging radiographs immobilization clinician trauma randomized controlled trial ct scan wrist orthopaedic surgeons Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/70e8dc808fbe44b68fda4bf0ac13e883
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spelling	oai:doaj.org-article:70e8dc808fbe44b68fda4bf0ac13e8832021-12-01T18:44:47ZThe management of suspected scaphoid fractures in the UK: a national cross-sectional study2633-146210.1302/2633-1462.211.BJO-2021-0146https://doaj.org/article/70e8dc808fbe44b68fda4bf0ac13e8832021-11-01T00:00:00Zhttps://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.211.BJO-2021-0146https://doaj.org/toc/2633-1462Aims: Current National Institute for Health and Clinical Excellence (NICE) guidance advises that MRI direct from the emergency department (ED) should be considered for suspected scaphoid fractures. This study reports the current management of suspected scaphoid fractures in the UK and assesses adherence with NICE guidance. Methods: This national cross-sectional study was carried out at 87 NHS centres in the UK involving 122 EDs and 184 minor injuries units (MIUs). The primary outcome was availability of MRI imaging direct from the ED. We also report the specifics of patient management pathways for suspected scaphoid fractures in EDs, MIUs, and orthopaedic services. Overall, 62 of 87 centres (71%) had a guideline for the management of suspected scaphoid fractures. Results: A total of 11 of 87 centres (13%) had MRI directly available from the ED. Overall, 14 centres (17%) used cross-sectional imaging direct from the ED: MRI in 11 (13%), CT in three (3%), and a mixture of MRI/CT in one (1%). Four centres (6%) used cross-sectional imaging direct from the MIU: MRI in three (4%) and CT in two (2%). Of 87 centres’ orthopaedic specialist services, 74 (85%) obtained repeat radiographs, while the most common form of definitive imaging used was MRI in 55 (63%), CT in 16 (19%), mixture of MRI/CT in three (3%), and radiographs in 11 (13%). Conclusion: Only a small minority of centres currently offer MRI directly from the ED for patients with a suspected scaphoid fracture. Further research is needed to investigate the facilitators and barriers to the implementation of NICE guidance. Cite this article: Bone Jt Open 2021;2(11):997–1003.Benjamin J. F. Dean*On behalf of the SUSPECT study groupThe British Editorial Society of Bone & Joint Surgeryarticlescaphoidfracturepathwaynicesuspectedwrist injuryscaphoid fracturesmagnetic resonance imagingradiographsimmobilizationcliniciantraumarandomized controlled trialct scanwristorthopaedic surgeonsOrthopedic surgeryRD701-811ENBone & Joint Open, Vol 2, Iss 11, Pp 997-1003 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	scaphoid fracture pathway nice suspected wrist injury scaphoid fractures magnetic resonance imaging radiographs immobilization clinician trauma randomized controlled trial ct scan wrist orthopaedic surgeons Orthopedic surgery RD701-811
spellingShingle	scaphoid fracture pathway nice suspected wrist injury scaphoid fractures magnetic resonance imaging radiographs immobilization clinician trauma randomized controlled trial ct scan wrist orthopaedic surgeons Orthopedic surgery RD701-811 Benjamin J. F. Dean *On behalf of the SUSPECT study group The management of suspected scaphoid fractures in the UK: a national cross-sectional study
description	Aims: Current National Institute for Health and Clinical Excellence (NICE) guidance advises that MRI direct from the emergency department (ED) should be considered for suspected scaphoid fractures. This study reports the current management of suspected scaphoid fractures in the UK and assesses adherence with NICE guidance. Methods: This national cross-sectional study was carried out at 87 NHS centres in the UK involving 122 EDs and 184 minor injuries units (MIUs). The primary outcome was availability of MRI imaging direct from the ED. We also report the specifics of patient management pathways for suspected scaphoid fractures in EDs, MIUs, and orthopaedic services. Overall, 62 of 87 centres (71%) had a guideline for the management of suspected scaphoid fractures. Results: A total of 11 of 87 centres (13%) had MRI directly available from the ED. Overall, 14 centres (17%) used cross-sectional imaging direct from the ED: MRI in 11 (13%), CT in three (3%), and a mixture of MRI/CT in one (1%). Four centres (6%) used cross-sectional imaging direct from the MIU: MRI in three (4%) and CT in two (2%). Of 87 centres’ orthopaedic specialist services, 74 (85%) obtained repeat radiographs, while the most common form of definitive imaging used was MRI in 55 (63%), CT in 16 (19%), mixture of MRI/CT in three (3%), and radiographs in 11 (13%). Conclusion: Only a small minority of centres currently offer MRI directly from the ED for patients with a suspected scaphoid fracture. Further research is needed to investigate the facilitators and barriers to the implementation of NICE guidance. Cite this article: Bone Jt Open 2021;2(11):997–1003.
format	article
author	Benjamin J. F. Dean *On behalf of the SUSPECT study group
author_facet	Benjamin J. F. Dean *On behalf of the SUSPECT study group
author_sort	Benjamin J. F. Dean
title	The management of suspected scaphoid fractures in the UK: a national cross-sectional study
title_short	The management of suspected scaphoid fractures in the UK: a national cross-sectional study
title_full	The management of suspected scaphoid fractures in the UK: a national cross-sectional study
title_fullStr	The management of suspected scaphoid fractures in the UK: a national cross-sectional study
title_full_unstemmed	The management of suspected scaphoid fractures in the UK: a national cross-sectional study
title_sort	management of suspected scaphoid fractures in the uk: a national cross-sectional study
publisher	The British Editorial Society of Bone & Joint Surgery
publishDate	2021
url	https://doaj.org/article/70e8dc808fbe44b68fda4bf0ac13e883
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The management of suspected scaphoid fractures in the UK: a national cross-sectional study

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