Association between lunate morphology and carpal collapse patterns in scaphoid nonunions.
OBJECTIVE
Type I lunates have a single distal facet for articulation with the capitate; type II lunates have an additional (medial) hamate facet on the distal articular surface. We retrospectively reviewed a series of patients with scaphoid nonunions to determine if there was an association between lunate morphology and the degree of carpal instability observed. Association between lunate morphology and the location of the scaphoid fracture (proximal or waist) was also investigated.


METHODS
Radiographs were evaluated for 45 patients with established scaphoid nonunions. Lunate morphology, scaphoid fracture location, and radiolunate angle were determined.


RESULTS
Type I lunates were present in 21 patients. Of these, 15 were found to have a dorsal intercalated segment instability pattern (radiolunate angle greater than 15 degrees ). By contrast, only 4 of the patients with type II lunates exhibited this pattern of instability. No significant association was found between lunate morphology and the scaphoid fracture location.


CONCLUSIONS
Type II lunate morphology is associated with significantly decreased incidence of dorsal intercalated segment instability (DISI) deformity in cases of established scaphoid nonunion (p = .0002). Lunate morphology, however, was not significantly associated with the location of the scaphoid fracture in these cases (p = .19).
Haase
Steven C
SC
Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA. shaase@med.umich.edu
Berger
Richard A
RA
Shin
Alexander Y
AY
D000293:Adolescent; D000328:Adult; D000368:Aged; D050824:Carpal Joints / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology