title: Three-dimensional analysis of osteophyte formation on distal radius following scaphoid nonunion.
abstract: BACKGROUND
  The purposes of this study were to quantitatively analyze osteophyte formation of the distal radius following scaphoid nonunion and to investigate how fracture locations relate to osteophyte formation patterns.
  
  
  METHODS
  Three-dimensional surface models of the scaphoid and distal radius were constructed from computed tomographic images of both the wrists of 17 patients' with scaphoid nonunion. The scaphoid nonunions were classified into 3 types according to the location of the fracture line: distal extra-articular (n = 6); distal intra-articular (n = 5); and proximal (n = 6). The osteophyte models of the radius were created by subtracting the mirror image of the contralateral radius model from the affected radius model using a Boolean operation. The osteophyte locations on the radius were divided into 5 areas: styloid process, dorsal scaphoid fossa, volar scaphoid fossa, dorsal lunate fossa, and volar lunate fossa. Osteophyte volumes were compared among the areas and types of nonunion. The presence or absence of dorsal intercalated segment instability (DISI) deformity was also determined.
  
  
  RESULTS
  The distal intra-articular type exhibited significantly larger osteophytes in the styloid process than the distal extra-articular type. Furthermore, the proximal type exhibited significantly larger osteophytes in the dorsal scaphoid fossa than the distal extra-articular type. Finally, the distal intra- and extra-articular types were more associated with DISI deformity and tended to have larger osteophytes in the lunate fossa than the proximal type.
  
  
  CONCLUSIONS
  The pattern of osteophyte formation in the distal radius determined using three-dimensional computed tomography imaging varied among the different types of scaphoid nonunion (distal extra-articular, distal intra-articular, and proximal). The results of this study are clinically useful in determining whether additional resection of osteophytes or radial styloid is necessary or not during the treatment of the scaphoid nonunion.
authors: Department of Orthopaedic Surgery, Japan Community Health Care Organization Osaka Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka 553-0003, Japan.
authors: Keiichiro
authors: K
authors: Oura
authors: Department of Physical Therapy, Osaka Yukioka College of Health Science, 1-1-41 Sojiji, Ibaraki-shi, Osaka 567-0801, Japan. Electronic address: moritomo@tcct.zaq.ne.jp.
authors: Hisao
authors: H
authors: Moritomo
authors: Department of Orthopaedic Surgery, Japan Community Health Care Organization Hoshigaoka Medical Center, 4-8-1 Hoshiga-oka, Hirakata, Osaka 573-8511, Japan.
authors: Toshiyuki
authors: T
authors: Kataoka
authors: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors: Kunihiro
authors: K
authors: Oka
authors: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors: Tsuyoshi
authors: T
authors: Murase
authors: Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors: Kazuomi
authors: K
authors: Sugamoto
authors: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors: Hideki
authors: H
authors: Yoshikawa
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology; D054850:Osteophyte / Q000000981:diagnostic imaging*; D056888:Patient Positioning; D011379:Prognosis; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D014954:Wrist Injuries / Q000000981:diagnostic imaging* / Q000601:surgery