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Scaphoid malunion.

P Nakamura1, T Imaeda, T Miura

  • 1Department of Orthopaedic Surgery, Branch Hospital of Nagoya, University School of Medicine, Japan.

The Journal of Bone and Joint Surgery. British Volume
|January 1, 1991
PubMed
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Symptomatic malunion of carpal scaphoid fractures causes pain and limited wrist function due to carpal deformity. Corrective osteotomy with bone grafting and internal fixation yields satisfactory outcomes for these injuries.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Biomechanics

Background:

  • Scaphoid fractures are common wrist injuries.
  • Malunion of scaphoid fractures can lead to significant morbidity.
  • Dorsiflexed intercalated segment instability (DISI) is a common consequence of scaphoid malunion.

Purpose of the Study:

  • To evaluate the clinical outcomes of patients with symptomatic malunion of carpal scaphoid fractures.
  • To investigate the relationship between the severity of DISI deformity and patient symptoms.
  • To assess the efficacy of corrective osteotomy for treating scaphoid malunion.

Main Methods:

  • Retrospective review of 10 patients with symptomatic scaphoid malunion.
  • Clinical assessment of pain, range of motion, and grip strength.

Related Experiment Videos

  • Radiographic evaluation of carpal alignment and DISI deformity.
  • Surgical treatment involving corrective osteotomy with anterior wedge bone graft and Herbert screw fixation in seven patients.

    • Main Results:

    • All patients presented with pain, restricted wrist motion, and decreased grip strength.
    • A correlation was observed between the severity of DISI deformity and the degree of flexion-extension restriction and grip strength reduction.
    • Seven patients underwent corrective osteotomy with satisfactory functional and symptomatic improvement.

    Conclusions:

    • Symptoms in scaphoid malunion are directly related to the resultant carpal deformity, particularly DISI.
    • Corrective osteotomy is an effective treatment for symptomatic scaphoid malunion, restoring wrist function.
    • Early diagnosis and treatment of scaphoid fractures are crucial to prevent malunion and subsequent carpal instability.