The objective is to illustrate the usefulness of the cone beam computed tomography (CBCT) in the detection of scaphoid fractures and their follow-up, being able to assess the state of consolidation trying to predict the evalution towards complete, incomplete or non-union healing.

Thanks to its relatively low irradiance compared to multidetector tomography (MDCT). CBCT may have a new role in imaging. Due to its high resolution. the CBCT allows to assess with great precision the presence or absence of fractures and to control their evolution. It also generates very low artifacts to the metal, being able to evaluate not only the hardware but also the bone lesions adjacent to it.

The CBCT images show greater sensitivity in the detection of bone trauma than conventional radiology (CR) and can visualize small hidden fractures or confirm doubtful fractures. In most cases, this has a very important benefit for the early treatment of injuries

The CBCT can provide more detailed information on bone architecture compared to CR, it can also help in evaluation of the healing process, which can be more or less underestimated in CR. The CBCT is superior to CR in the evaluation of the formation of bone bridges or the presence is superior to CR in the evaluation of the formation of bone bridges or the presence of lines of residual fractures. In cases of postoperative follow-up after the placement of lines of residual hardware, CBCT can facilitate the diagnosis of non-union, incomplete or total healing as well as the early detection of loosing or rupture of the hardware

CBCT is a very useful method for the evaluation of scaphoid fractures, particularly when CR is negative or doubtful despite the high suspicion of fractures. The excellent quality of the trabecular image, the low dose and the few artifacts to the metallic hardware make it the methods of choice for the follow-up of the healing

Ricardo Trueba, MD. Physician specialized in Radiology. Subspecialist in trauma and sports pathology. Fellowships in Spain and the United States. He works at the Rostagno Medical Group.

Member of several national and international radiological societies (RSNA- ESR).

Former coordinator of the musculoskeletal chapter of the Argentine Society of Radiology (SAR).