Comparison of Computed Tomography Scan and Plain Radiograph for the Assessment of Postoperative unio‎n in Patients Treated for Scaphoid Nonunio‎n

The appropriate monitoring of unio‎n following the treatment of scaphoid nonunio‎n is essential. However, there is no consensus regarding the optimal imaging modality for this evaluation. Objectives: Here, we compared the reliability of plain radiographs with Computed Tomography (CT) scanning in determining the unio‎n of scaphoid following the scaphoid nonunio‎n. Methods: In this retrospective study, 25 patients, who underwent the surgical treatment of scaphoid nonunio‎n and had both plain radiographs and CT images, were included. The surgical procedure included open reduction, illiac crest bone graft, and K-wire fixation. Two different observers assessed the healing of scaphoid nonunio‎n by both imaging modalities and graded as healed or non-healed. Results: The Mean±SD age of the patients was 29.1±6.8 years. The Mean±SD time interval from the operation to imaging was 6.5±2.5 months. Based on the plain radiographs, all patients achieved the scaphoid unio‎n. However, in the CT evaluation, 23(92%) patients showed the scaphoid unio‎n. Accordingly, CT images and plain radiographs agreed in 23 cases and disagreed in two cases. This difference was not statistically significant (P=0.5). Conclusion: In a subset of patients, who underwent the operation for the treatment of scaphoid nonunio‎n, plain radiographs might falsely confirm a scaphoid unio‎n. In these patients, a complementary CT evaluation might be helpful in the accurate assessment of scaphoid healing.