To evaluate the effectiveness of a new ambulatory pathway using cone beam CT (CBCT) for diagnosing suspected scaphoid fractures in the emergency department, focusing on the proportion of patients receiving timely imaging.
Approach:
Study Design: A prospective interventional before-and-after study conducted between 1 August 2022 and 31 May 2023, comparing a newly designed CBCT pathway with previous care practices.
Setting: Implemented in a level 4 teaching institution and trauma-receiving hospital in Dublin, Ireland, with an annual attendance of 100,000 patients.
Key Findings:
The new CBCT pathway increased the proportion of patients undergoing CBCT within 7 days of initial presentation.
The pathway has the potential to decrease time to definitive imaging for suspected scaphoid fractures.
Interpretation:
Integrating a dedicated CBCT pathway into outpatient management can improve early diagnosis and expedite patient care for suspected scaphoid fractures.
Limitations:
The study was uncontrolled and conducted at a single institution.
Exclusion criteria may limit generalizability to broader populations.
Conclusion:
The study indicates that CBCT can serve as an effective alternative to MRI for diagnosing scaphoid fractures.
