Objective:

The aim of the present study was to identify the pain level for guidence to get computerized tomography imaging in patients with wrist trauma who were not diagnosed to have distal radius fracture on radiography.

Material and Methods:

The patients over 18 years old, who were admitted to the Okmeydanı Training and Research Hospital emergency department between January 2016 and June 2016 with the complaint of hand-wrist trauma and and no wrist fracture was detected on conventional x rays were included in this study. The patients under 18 years of age, with a history of previous wrist fracture, infection, surgery, arthritis, open fractures, malunion, patients with a mental disorder were not included in the study. Follow up period was determined as for 6 months. 5 different anatomic palpation points were marked as A,B,C,D,E. Points were palpated and VAS score for each region were separately measured. CT was performed to the patients whose VAS score was over 5 point by palpation at any anatomic points regardless of swelling and ecchymosis. The patients who were diagnosed to have fracture on CT underwent proper treatment.

Results:

There were 26 (%60,4) males and 17 (%39.6) females. The right wrist was involved in 48,8% (18 cases), the left in 51,2% (21) of our cases. Average VAS scores of the patients without fracture after ct imaging by palpation at point A 4.3, point B: 5.09, point C: 4.3,point D: 3.09, point E: 2.3 were founded. When comparing the two groups the average value for each inspection point, these values were significantly higher in the fracture group. We found that the average VAS score in the group with fractures in our study at point A was %22 (2.2) higher than the others. This value were founded 1.91 at point B,3 at point C,0.6 at point D, 2.6 at point E.

Conclusion:

Results of this study suggests that despite the lack of radiological fracture diagnosis,computed tomograpy imaging help us to prevent undiagnosed any wrist fracture if the patients have severe pain when admitted to emergency department with wrist trauma.

Keywords: computed tomography, fracture, pain, wrist travma