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Factors associated with arthroscopically determined scaphoid fracture displacement and instability
Geert A Buijze1, Peter Jørgsholm, Niels O B Thomsen
1Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Purpose:
To identify factors associated with arthroscopically diagnosed scaphoid fracture displacement and instability.
Methods:
This was a secondary use of data from 2 prospective cohort studies. The studies included 58 consecutive adult patients with a scaphoid fracture who elected arthroscopy-assisted operative fracture treatment: some for displacement, some as part of a prospective protocol, and others to avoid a cast. All patients had preoperative computed tomography with reconstructions in planes defined by the long axis of the scaphoid.
Results:
Arthroscopy revealed 38 unstable fractures (movement between fracture fragments; 66%), 27 of which were also displaced. All arthroscopically determined displaced fractures were unstable, and 11 of the 31 arthroscopically determined, nondisplaced fractures were unstable. There was a significant correlation between radiographic comminution (more than 2 fracture fragments) and arthroscopically determined displacement and instability.
Conclusions:
Radiographic comminution is associated with displacement and instability as determined by arthroscopy.
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