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Dorsal intercalated segmental instability associated with malunion of a reconstructed scaphoid

2016; SAGE Publishing; Volume: 42; Issue: 3 Linguagem: Inglês

10.1177/1753193416680133

2043-6289

J.-H. Kim, K.-H. Lee, Bong Gun Lee, C.-H. Lee, Su Jung Kim, Wan-Sun Choi,

Medical Malpractice and Liability Issues

We analysed scaphoid deformity as a result of surgical treatment of scaphoid fracture nonunion and assessed the deformity associated with a dorsal intercalated segmental instability pattern of carpal malalignment. A total of 45 patients who were treated for scaphoid fracture nonunion were included in the study. The height-to-length ratio of the scaphoid was measured on computed tomographic images and used to assess scaphoid deformity. Carpal malalignment was quantified based on the radio-lunate angle. A correlation analysis between the height-to-length ratio and the radio-lunate angle was performed. Dorsal intercalated segmental instability was defined as a radio-lunate angle >15°, and a receiver operating curve analysis was used to calculate the cutoff height-to-length ratio that can be accompanied with dorsal intercalated segmental instability. Extension of the lunate increases in proportion to the flexion deformity of the scaphoid; dorsal intercalated segmental instability can occur if the height-to-length ratio of the scaphoid is >0.73. Level of evidence: IV