Scaphoid malunion.
Forty-five patients with 46 scaphoid fractures were studied more than 6 months after union by clinical examination and trispiral tomography. Twenty had normal scaphoid alignment with lateral intrascaphoid angles less than 35 degrees; the rest had varying degrees of increased flexion angulation of the scaphoid, ranging from 36 degrees to 60 degrees. Increasing lateral scaphoid angulation, eventually resulting in a "humpback" deformity, was associated with progressively poor clinical and radiographic results. There were satisfactory clinical outcomes in 83% and posttraumatic arthritis in only 22% of those with normal scaphoid anatomy. Those with greater than 45 degrees of lateral intrascaphoid angulation present at the time of union had a satisfactory clinical outcome in 27% and posttraumatic arthritis in 54%. Union alone is an insufficient criterion for success in treating scaphoid fractures.
Amadio
P C
PC
Department of Orthopedics, Mayo Clinic, Rochester, Minn. 55905.
Berquist
T H
TH
Smith
D K
DK
Ilstrup
D M
DM
Cooney
W P
WP
Linscheid
R L
RL
D000293:Adolescent; D000328:Adult; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D004599:Electric Stimulation Therapy; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D005599:Fractures, Ununited / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008297:Male; D014056:Tomography, X-Ray