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Quantifying scaphoid malalignment based upon height-to-length ratios obtained by 3-dimensional computed tomography.

Paul W L ten Berg1, Johannes G G Dobbe1, Simon D Strackee1

  • 1Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

The Journal of Hand Surgery
|December 24, 2014
PubMed
Summary
This summary is machine-generated.

Adding coronal plane measurements to height-to-length (H/L) ratios improves detection of scaphoid fracture malalignment. Waist nonunions are more frequently malaligned than proximal pole nonunions, aiding surgical decisions.

Keywords:
3D-CTScaphoid deformitydeformity measurementscaphoid malunionscaphoid nonunion

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Area of Science:

  • Orthopedic surgery
  • Radiology
  • Biomechanical analysis

Background:

  • Scaphoid fractures are common wrist injuries.
  • Malalignment of scaphoid nonunions can lead to poor outcomes.
  • Accurate detection of malalignment is crucial for treatment planning.

Purpose of the Study:

  • To assess if 3-dimensional height-to-length (H/L) measurements, including coronal plane assessment, enhance malalignment detection in scaphoid fractures.
  • To compare malalignment rates between waist and proximal pole scaphoid nonunions.

Main Methods:

  • Developed 3D models of healthy scaphoids from CT scans (n=74) to establish normal H/L ratio ranges.
  • Determined normal H/L ranges in sagittal and coronal planes.
  • Compared H/L ratios of scaphoid nonunions (n=26) to normal ranges, classifying them as aligned or malaligned.

Main Results:

  • Coronal plane H/L ratio assessment increased malalignment detection from 46% (sagittal only) to 54% (sagittal + coronal).
  • Waist nonunions showed significantly higher malalignment rates (71%) compared to proximal pole nonunions (22%).
  • Mean H/L ratios in nonunions differed from normal ranges in both sagittal and coronal planes.

Conclusions:

  • Coronal plane H/L ratio evaluation is valuable for detecting scaphoid deformities.
  • Waist nonunions are more prone to malalignment than proximal pole nonunions.
  • This H/L ratio method can aid in diagnosing malalignment and guiding treatment choices.