Scaphoid Fracture management in Children , Version 1.1
Research type
Research Study
Full title
Scaphoid Fracture management in Children: new algorithm based on Clinical Scaphoid Score optimising Diagnosis and Treatment.
IRAS ID
189181
Contact name
Kerstin Oestreich
Contact email
Sponsor organisation
Birmingham Children's Hospital
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
The Scaphoid is the commonest small bone of the wrist fractured when an individual falls on their outstretched hand. Fractures of this bone are difficult to diagnose in the acute setting and further investigations including imaging may be required. Magnetic Resonance Imaging (MRI) scan is widely accepted as the imaging modality of choice, but is expensive, time consuming and not readily available in the emergency setting.
A scoring system, tested in Adults, has been shown to help predict likelihood of scaphoid fracture and hence guide which patients require MRI scan.
Objective: To investigate usefulness of a scoring system - Clinical Scaphoid Score (CSS) based on 3 commonly performed clinical tests, in predicting presence or absence of Scaphoid fractures in children, with MRI scan as the Standard investigation for confirmation.
Design: Prospective trial.
Centre: Birmingham Children´s Hospital (BCH)
Intervention: Over a period of one year all children 6 to 16 years of age presenting to BCH emergency department and Hand Trauma Clinic with a history of fall on outstretched hand and wrist pain, will be enrolled subject to informed consent. CSS will be calculated from standardised testing by experienced clinicians in Emergency department or dedicated Hand Clinics at first point of contact. Plain X-ray of wrist will be carried out in all cases, at first attendance. An MRI scan will also be carried out for all patients who enter the study.
Treatment and follow up: Children with confirmed fracture or CSS of 4 or higher will be treated according to configuration of fracture either surgically or conservatively. This could involve placing them in a protective plaster cast for up to 6 weeks and final review 6 months from injury. Those who score less than 4 or have negative MRI scan will be offered removable splints and follow up on request only.REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
18/WM/0111
Date of REC Opinion
5 Jun 2018
REC opinion
Further Information Favourable Opinion