# The Medium-Term Outcomes of Patients With Suspected Scaphoid Fractures: A Single-Centre Retrospective Cohort Study

## TL;DR

This study examines the medium-term outcomes of patients with non-specific wrist injuries treated as suspected scaphoid fractures, finding that most experience mild pain and disability.

## Contribution

The study provides new insights into the medium-term outcomes of patients managed for suspected scaphoid fractures without a confirmed diagnosis.

## Key findings

- Most patients reported mild pain and disability, with a median PRWE score of 32.
- A minority of patients experienced severe or very severe pain and disability.
- Patients had the most difficulty lifting heavy objects despite low pain at rest.

## Abstract

Background

The medium-term outcomes of patients (six to 14 months post-injury) with non-specific wrist injuries managed as suspected scaphoid fractures are not clear from the current literature. These patients’ wrists are immobilized in casts or splints, and some receive physiotherapy. They receive serial imaging and follow-up appointments as needed.

Aims

This study aims to describe the medium-term outcomes of patients with non-specific wrist injuries managed as suspected scaphoid fractures.

Methods

This is a single-centre retrospective cohort study. Patients with suspected scaphoid fractures were identified from a consecutive database and were included. Patients diagnosed with a definitive scaphoid fracture at any point in time were excluded. Patients with any pre-existing wrist pathology were also excluded.

In total 113 patients were posted the Patient-Rated-Wrist-Evaluation (PRWE) questionnaire at six to 14 months post-injury with a self-addressed return envelope. Demographic and PRWE data were collated and described.

Results

Twenty-two patients (19% of total patients) returned a completed questionnaire. The median PRWE score was 32 out of 100 indicating mild pain and disability. 45.5% of patients were in this category. A minority of patients (9%) continued to suffer severe or very severe pain and disability. Patients with PRWE scores <40, representing pain and disability that is mild or less, reported very low difficulty completing work and recreational activities. Patients tended not to have pain at rest and experienced the most difficulty lifting heavy objects.

Conclusion

Most patients with non-specific wrist injuries managed as suspected scaphoid fractures experience some pain and disability in the medium term. For most this is minimal or mild, however some patients experience significant pain and disability. This study adds to existing evidence that this is the case. The reasons why these patients suffer are unclear. This study highlights the need to refine clinical practice to improve the outcomes of these patients.