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Related Experiment Video

Updated: Oct 21, 2025

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How Is Scaphoid Malunion Defined: A Systematic Review.

Michelle Xiao1, Jessica M Welch1, Samuel A Cohen1

  • 1Stanford University, Redwood City, CA, USA.

Hand (New York, N.Y.)
|September 6, 2021
PubMed
Summary

Defining scaphoid malunion lacks consensus, with imaging parameters varying widely. Current imaging definitions do not correlate with patient outcomes after scaphoid fracture fixation.

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Area of Science:

  • Orthopedic surgery
  • Radiology
  • Biomechanical engineering

Background:

  • Scaphoid fracture malunion is an indication for surgical fixation, but acceptable alignment is not well-defined.
  • A systematic review was conducted to identify current definitions and parameters for scaphoid malunion.

Approach:

  • Systematic review of English-language studies using PRISMA guidelines.
  • Collected radiographic parameters and clinical outcomes (grip strength, range of motion, patient-reported outcomes).
  • Assessed study quality using Methodological Index for Non-Randomized Studies (MINORS) criteria.

Key Points:

  • Ten studies (161 participants) were analyzed, with significant variation in defining scaphoid malunion (e.g., lateral intrascaphoid angle >45° or >35°, height to length ratio >0.6).
Keywords:
deformityhand surgerymalunionpatient-reported outcome measuresscaphoid

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  • Four out of five studies found no significant association between radiographic malunion measurements and patient outcomes.
  • High variability in defining scaphoid malunion and lack of correlation with patient outcomes were observed.

    • Conclusions:

    • There is a lack of consensus in defining scaphoid malunion via imaging.
    • Current imaging parameters for scaphoid malunion do not correlate with patient outcomes.
    • Future research should focus on standardized definitions, reliability measures, and validated patient-reported outcomes.