Diagnostic work-up of suspected scaphoid fractures

The diagnostic work-up of patients with (suspected) scaphoid fractures is flawed by “underdiagnosis” and “over-treatment”.
We are unable to identify all scaphoid fractures during patients’ initial visit in Emergency Department, if we continue to rely on painful anatomic snuffbox on clinical examination and plain radiographs as the mainstay of diagnostic imaging. To assure that we do not miss – “underdiagnose” – any scaphoid fractures and do not unnecessarily “over”-treat patients, we have to improve our diagnostic protocol from both clinical- as well as imaging perspectives.
The overall aim of this PhD Thesis was to assess current management and to improve both clinical and diagnostic strategies, in order to create a new and more efficient protocol that leads to earlier and more accurate diagnosis, reduces overtreatment, follow-up imaging and outpatient clinic visits without an increased risk of missing a fracture.