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The Effect of Scaphoid Overstuffing on Radiocarpal Contact Pressures.

Charles T Tuggle1, Keith T Aziz1,2, Sierra Lindsey1,3

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Hand (New York, N.Y.)
|March 29, 2026
PubMed
Summary

Scaphoid overstuffing, a technique for scaphoid nonunions, increases peak pressures on the scaphoid facet. This may lead to accelerated cartilage degeneration, requiring further clinical investigation.

Keywords:
medial femoral trochlea flapproximal polescaphoid nonunionscaphoid overstuffingscapholunate ligament

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Area of Science:

  • Orthopedic surgery
  • Biomechanics
  • Hand surgery

Background:

  • The medial femoral trochlea flap technique addresses recalcitrant scaphoid proximal pole nonunions.
  • This method involves resecting part of the scapholunate interosseous ligament but preserves intercarpal alignment.
  • Scaphoid reconstruction with an oversized osteochondral flap, termed scaphoid overstuffing, maintains lunate alignment despite ligament loss.

Purpose of the Study:

  • To analyze the impact of scaphoid overstuffing on force transmission across the scaphoid and lunate facets of the radius.

Main Methods:

  • Eleven fresh frozen cadaveric wrists without ligament instability were used.
  • Electronic pressure sensors measured pressures in the radiocarpal joint under native, scapholunate dissociation (SLD), and overstuffed (OS) conditions.
  • Pressure data were collected in four wrist positions: 30° flexion, full extension, 30° extension, and clenched fist.

Main Results:

  • The overstuffed (OS) state consistently showed higher peak pressures on the scaphoid facet across all tested functional wrist positions.
  • Significant increases in peak pressure were observed in 30° wrist flexion (OS 383 ± 221 kPa), full wrist extension (OS 1068 ± 767 kPa), 30° wrist extension (OS 880 ± 518 kPa), and clenched fist (OS 1040 ± 736 kPa).

Conclusions:

  • Scaphoid overstuffing elevates peak contact pressures at the scaphoid facet during functional wrist movements.
  • Long-term clinical implications, including potential accelerated cartilage degeneration, warrant additional research.