title: Analysis of deformity in scaphoid non-unions using two- and three-dimensional imaging.
abstract: Pre-operative assessment of the deformity in scaphoid non-unions influences surgical decision-making. To characterize deformity, we used three-dimensional computed tomographic modelling in 28 scaphoid non-unions, and quantified bone loss, dorsal osteophyte volume and flexion deformity. We further related these three-dimensional parameters to the intrascaphoid and capitate-lunate angles, and stage of scaphoid non-union advanced collapse assessed on conventional two-dimensional images and to the chosen surgical procedure. Three-dimensional flexion deformity (mean 26°) did not correlate with intrascaphoid and capitate-lunate angles. Osteophyte volume was positively correlated with bone loss and stage of scaphoid non-union advanced collapse. Osteophyte volume and bone loss increased over time. Three-dimensional modelling enables the quantification of bone loss and osteophyte volume, which may be valuable parameters in the characterization of deformity and subsequent decision-making about treatment, when taken in addition to the clinical aspects and level of osteoarthritis.
  
  
  METHODS
  Level IV.
authors.affiliation: Department of Plastic, Reconstructive, and Hand Surgery, University of Amsterdam, Amsterdam, The Netherlands paultenberg@hotmail.com.
authors.forename: P W L
authors.initials: PW
authors.lastname: Ten Berg
authors.affiliation: Department of Biomedical Engineering and Physics, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: J G G
authors.initials: JG
authors.lastname: Dobbe
authors.affiliation: Department of Plastic, Reconstructive, and Hand Surgery, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: S E R
authors.initials: SE
authors.lastname: Horbach
authors.affiliation: Department of Orthopaedic Surgery, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: R M
authors.initials: RM
authors.lastname: Gerards
authors.affiliation: Department of Plastic, Reconstructive, and Hand Surgery, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: S D
authors.initials: SD
authors.lastname: Strackee
authors.affiliation: Department of Biomedical Engineering and Physics, University of Amsterdam, Amsterdam, The Netherlands Department of Radiology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: Streekstra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005599:Fractures, Ununited / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D054850:Osteophyte; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging* / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Scaphoid deformity; graft reconstruction; reconstructive surgery; scaphoid non-union; three-dimensional computed tomography