Factors associated with arthroscopically determined scaphoid fracture displacement and instability.
OBJECTIVE
To identify factors associated with arthroscopically diagnosed scaphoid fracture displacement and instability.


METHODS
This was a secondary use of data from 2 prospective cohort studies. The studies included 58 consecutive adult patients with a scaphoid fracture who elected arthroscopy-assisted operative fracture treatment: some for displacement, some as part of a prospective protocol, and others to avoid a cast. All patients had preoperative computed tomography with reconstructions in planes defined by the long axis of the scaphoid.


RESULTS
Arthroscopy revealed 38 unstable fractures (movement between fracture fragments; 66%), 27 of which were also displaced. All arthroscopically determined displaced fractures were unstable, and 11 of the 31 arthroscopically determined, nondisplaced fractures were unstable. There was a significant correlation between radiographic comminution (more than 2 fracture fragments) and arthroscopically determined displacement and instability.


CONCLUSIONS
Radiographic comminution is associated with displacement and instability as determined by arthroscopy.
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Geert A
GA
Buijze
Peter
P
Jørgsholm
Niels O B
NO
Thomsen
Anders
A
Björkman
Jack
J
Besjakov
David
D
Ring
D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome