title: 3-dimensional analysis of scaphoid fracture angle morphology.
abstract: OBJECTIVE
  Scaphoid fractures are classified according to their 2-dimensional radiographic appearance, and transverse waist fractures are considered the most common. Our hypothesis was that most scaphoid fractures are not perpendicular to the longitudinal axis of the scaphoid (ie, not transverse).
  
  
  METHODS
  Computerized 3-dimensional analyses were performed on 124 computed tomography scans of acute scaphoid fractures. Thirty of the fractures were displaced and virtually reduced. The angle between the scaphoid's first principal axis (longitudinal axis) and the fracture plane was analyzed for location and displacement. The distal radius articular surface was used to depict the volar-dorsal vector of the wrist.
  
  
  RESULTS
  There were 86 fractures of the waist, 13 of the distal third, and 25 of the proximal third. The average angle between the scaphoid longitudinal axis and the fracture plane was 53° for all fractures and 56° for waist fractures, both differing significantly from a 90°, transverse fracture. The majority of fracture planes were found to have a volar distal to dorsal proximal (horizontal oblique) inclination relative to the volar-dorsal vector.
  
  
  CONCLUSIONS
  Most waist fractures were horizontal oblique and not transverse. According to these findings, fixation of all fractures along the longitudinal axis of the scaphoid may not be the optimal mode of fixation for most. A different approach may be needed in accordance with the fracture plane.
  
  
  METHODS
  Diagnostic II.
authors.affiliation: Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Plastic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address: shail@hadassah.org.il.
authors.forename: Shai
authors.initials: S
authors.lastname: Luria
authors.affiliation: Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Plastic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Yonatan
authors.initials: Y
authors.lastname: Schwarcz
authors.affiliation: Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Plastic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Ronit
authors.initials: R
authors.lastname: Wollstein
authors.affiliation: Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Plastic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Emelife
authors.affiliation: Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Plastic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Gershon
authors.initials: G
authors.lastname: Zinger
authors.affiliation: Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Plastic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Eran
authors.initials: E
authors.lastname: Peleg
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Scaphoid fracture; fracture morphology; longitudinal axis; principal component analysis; wrist fracture