title: Radiographic clues for determining carpal instability and treatment protocol for scaphoid fractures.
abstract: The magnitude of carpal instability following scaphoid fracture is closely related to the fracture location. Middle-third fractures of the scaphoid are classified into B1 (distal oblique fractures) and B2 (complete waist fractures). Deciding preoperatively whether a fracture is B1 or B2 is clinically important, because several studies have revealed that B1 is more stable than B2. Dorsal intercalated segment instability deformity often develops in B2, creating a large, wedge-shaped bone defect, while minimal humpback deformity develops in B1, and the bone defect is much smaller, even after long-standing nonunions. However, determination of the fracture types using X-rays may be less accurate than using three dimensional computed tomography. This article suggests two radiographic clues for estimation of post-fracture carpal instability along with a treatment protocol for each fracture type.
authors.affiliation: Yukioka Hospital Hand Center, Osaka Yukioka College of Health Science, 2-2-3 Ukita, Kita-ku, Osaka-shi, Osaka, 530-0021, Japan, hisao-moritomo@yukioka-u.ac.jp.
authors.forename: Hisao
authors.initials: H
authors.lastname: Moritomo
mesh_terms: D050723:Fractures, Bone / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D021361:Scaphoid Bone / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014955:Wrist Joint / Q000000981:diagnostic imaging*