392 The Role of MRI in the Management of Scaphoid Fractures: A Closed-Loop Audit by Dorset County Hospital, UK

Abstract Prompt and accurate diagnosis of scaphoid fractures are crucial in preventing complications such as non-union, avascular necrosis & early-onset arthritis. Research has shown that initial radiographs detect a fracture 85–90% cases, but it can be occult up to 10–15%. In 2016 NICE recommended MRI should considered for first-line imaging patients with suspected fractures. Our aim is determine whether the clinical practice at DCH matched recommendations set by NICE, implementation ‘Scaphoid Management Protocol’ led increased compliance. Retrospective analysis all presenting ED between May – September 2017, reaudit December 2017 - February 2018 June October 2020. Those who had gone on have further were then identified, average time taken requests being performed was evaluated. Prior protocol, 16% normal X-ray signs weren't referred this reduced 1% re-audit. The recorded from requested date improved each audit cycle, 37.6, 19.9 11.4 days, respectively. However, new finding found 35% injury not Orthopaedic assessment exclude fracture. Implementation significantly compliance guidelines resulting earlier prognosis, well improving request date.