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The Palpable Scaphoid Surface Area in Various Wrist Positions
Juan M Giugale1, Daniel Leigey1, Kyle Berkow2
1Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
The Journal of Hand Surgery
|August 27, 2015
Summary
Optimal palpation of the scaphoid bone involves specific wrist positioning. Different wrist positions maximize the surface area for detecting proximal pole, waist, or distal pole fractures.
Area of Science:
- Orthopedic surgery
- Anatomy
- Biomechanics
Background:
- Scaphoid fractures are common wrist injuries.
- Accurate palpation is crucial for diagnosis.
- Optimal wrist positioning for scaphoid palpation is not well-defined.
Purpose of the Study:
- To determine the theoretical surface area for scaphoid palpation in various wrist positions.
- To guide optimal wrist positioning for detecting specific scaphoid fracture locations (proximal pole, waist, distal pole).
Main Methods:
- Utilized 3 fresh-frozen male cadaver wrists.
- Digitized palpable surface areas of the scaphoid in multiple wrist positions.
- Created 3D reconstructions of the scaphoid for superimposition and surface area calculation.
Main Results:
- Maximum palpable surface area achieved with neutral wrist extension/ulnar deviation or maximum flexion/neutral deviation.
- Neutral extension/ulnar deviation ideal for detecting waist and larger proximal pole fractures.
- Maximum flexion ideal for detecting proximal pole fractures.
Conclusions:
- Wrist position significantly impacts scaphoid palpation surface area.
- Consider specific wrist positions during examination for suspected scaphoid fractures.
- Palpate scaphoid in three regions using varied wrist positions to maximize exposure.
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