What value the scaphoid compression test?

It has been suggested that a positive scaphoid compression test will reliably confirm the presence of a fractured scaphoid in those patients presenting with an injury clinically suggestive of this, but without a fracture visible on initial X-rays. A prospective study was carried out in 99 patients presenting with an injury clinically suggestive of a scaphoid fracture. 74 patients had positive scaphoid compression tests with 24 of these patients having a scaphoid fracture visible on initial X-ray and seven having a fracture diagnosed either by repeat X-ray or bone scan 2 weeks after injury. 25 patients had a negative test, with ten having a scaphoid fracture visible on initial X-ray and three on repeat X-ray at 2 weeks. These results show that this test had a sensitivity of 70.5%, a specificity of 21.8% and predictive value of 41.9%. A positive scaphoid compression test is an unreliable diagnostic aid for a scaphoid fracture.