title: Scaphoid interfragmentary motions due to simulated transverse fracture and volar wedge osteotomy.
abstract: BACKGROUND
  Our goal was to determine 3-dimensional interfragmentary motions due to simulated transverse fracture and volar wedge osteotomy of the scaphoid during physiologic flexion-extension of a cadaveric wrist model.
  
  
  METHODS
  The model consisted of a cadaveric wrist (n = 8) from the metacarpals through the distal radius and ulna with load applied through the major flexor-extensor tendons. Flexibility tests in flexion-extension were performed in the following 3 test conditions: intact and following transverse fracture and wedge osteotomy of the scaphoid. Scaphoid interfragmentary motions were measured using optoelectronic motion tracking markers. Average peak scaphoid interfragmentary motions due to transverse fracture and wedge osteotomy were statistically compared (P<0.05) to intact.
  
  
  RESULTS
  The accuracy of our computed interfragmentary motions was ± 0.24 mm for translation and ± 0.54° for rotation. Average peak interfragmentary motions due to fracture ranged between 0.9 mm to 1.9 mm for translation and 5.3° to 10.8° for rotation. Significant increases in interfragmentary motions were observed in volar/dorsal translations and flexion/extension due to transverse fracture and in separation and rotations in all 3 motion planes due to wedge osteotomy.
  
  
  CONCLUSIONS
  Comparison of our results with data from previous in vitro and in vivo biomechanical studies indicates a wide range of peak interfragmentary rotations due to scaphoid fracture, from 4.6° up to 30°, with peak interfragmentary translations on the order of several millimeters. Significant interfragmentary motions, indicating clinical instability, likely occur due to physiologic flexion-extension of the wrist in those with transverse scaphoid fracture with or without volar bone loss.
authors: Biomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA. Electronic address: paul.ivancic@yale.edu.
authors: Paul C
authors: PC
authors: Ivancic
authors: Biomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA.
authors: Ameya V
authors: AV
authors: Save
authors: Biomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA.
authors: Erik J
authors: EJ
authors: Carlson
authors: Biomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA.
authors: Seth D
authors: SD
authors: Dodds
mesh_terms: D001696:Biomechanical Phenomena; D002102:Cadaver; D050723:Fractures, Bone / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology; D009068:Movement / Q000502:physiology*; D010027:Osteotomy / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery; D014955:Wrist Joint / Q000502:physiology
keywords: Biomechanics; Fracture; Interfragmentary motion; Scaphoid; Wrist