UNASSIGNED: Introduction: @entity174 in @entity1 are rare, but can be missed, as their clinical symptoms are unspecific and discrete. Even X-ray diagnosis is difficult. Timely diagnosis and consistent therapy are especially important for scaphoid @entity174 , as they can help to avoid complications such as non-union or avascular @entity39 . A diagnostic approach to paediatric @entity174 will be discussed on the basis of the following group of @entity1 . Methods: Retrospective analysis of @entity1 under 14 years treated in our institution between 09/2010 and 02/2012 for clinically suspected @entity174 . In the primary evaluation, all @entity1 underwent standard X-rays of the hand and/or wrist. All @entity1 were treated by cast immobilisation until complete clinical recovery. All @entity1 with clinical signs of @entity174 were treated by cast immobilization, even with normal X-rays. The clinical follow-up examination was after 10 to 14 days. In @entity1 with persistent complaints, MRI was performed. We retrospectively evaluated the records of all @entity1 : the @entity174 , and X-ray and MRI-diagnosis were stated. We calculated the mean difference between first presentation and MRI and the mean period for total recovery, in @entity1 with @entity174 or @entity174 . Results: 61 @entity1 (27 @entity1 and 34 @entity1 , mean age 11.5   y) were included in our study. The mean delay between accident and time of first presentation to our paediatric ED was 0.6 days. In primary X-rays, a @entity174 was demonstrated in only in 2 (3.3%) @entity1 , but was suspected in only 6 (9.8%) of @entity1 . In 53 (87.9%) @entity1 , there was no radiographic evidence of @entity174 . 14 @entity1 underwent additional scaphoid views, but @entity174 was confirmed in only 1 (7%) of these @entity1 . In 3 (21.4%) @entity1 , a @entity174 was suspected and in 10 @entity1 a @entity174 could be excluded. After a mean time of 11.8 days, all @entity1 underwent a clinical follow-up examination. 32 (54%) @entity1 had persistent symptoms and MRI was done after a mean time of 17 days. @entity174 was then excluded in 12/32 (37%) @entity1 and was diagnosed in another 20/32 (63%) @entity1 . There were 14 scaphoid @entity174 , including 3* @entity79 , 4 capitate @entity174 , 3 triquetral @entity174 , including 1* @entity79 and 1 @entity79 of the trapezoid. In @entity1 with proven @entity174 , it took a mean time of 56 days for complete recovery, in comparison with 15 days in @entity1 with excluded @entity174 . Surgical therapy was unnecessary in any of the @entity1 , and there were no complications. Conclusion: In @entity1 with clinical and radiographic @entity174 , diagnosis is difficult and often unsuccessful at first. Even in discrete clinical complaints, generous cast immobilization is essential and clinical follow up is recommended not later then 14 days. In @entity1 with persistent clinical symptoms, MRI is the imaging method of choice, as it is capable of detecting @entity174 and even @entity79 with high sensitivity, thereby avoiding unnecessary diagnostic or therapeutic stress for the @entity1 .

[Diagnostically Approach to XXXX : a Retrospective Analysis].

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'girls', 'boys'] @entity79 :: ('MESH:D001847', 'Disease') :: ['bone bruise lesion', 'bone bruise lesions'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'carpal fractures', 'carpal fracture', 'scaphoid fracture', 'Carpal fractures', 'non-fracture', 'Carpal fracture', 'fracture', 'fractured carpal bone'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis']
@entity174 :: (MESH:D050723,Disease) :: ['Pediatric Carpal Fractures']
