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Bulstra AEJ, Al-Dirini RMA, Turow A, Oldhoff MGE, Bryant K, Obdeijn MC, Doornberg JN, Jaarsma RL, Bain GI. The influence of fracture location and comminution on acute scaphoid fracture displacement: three-dimensional CT analysis. J Hand Surg Eur Vol 2021; 46:1072-1080. [PMID: 34472394 DOI: 10.1177/17531934211040962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We aimed to assess the influence of fracture location and comminution on acute scaphoid fracture displacement using three-dimensional CT. CT scans of 51 adults with an acute scaphoid fracture were included. Three-dimensional CT was used to assess fracture location, comminution and displacement. Fracture location was expressed as the height of the cortical breach on the volar and dorsal side of the scaphoid relative to total scaphoid length (%), corresponding to the fracture's entry and exit point, respectively. We found a near-linear relation between dorsal fracture location and displacement. As dorsal fracture location became more distal, translation (ulnar, proximal, volar) and angulation (flexion, pronation) of the distal fragment relative to the proximal fragment increased. Comminuted fractures had more displacement. Dorsal fracture location predictably dictates the direction of translation and angulation in displaced scaphoid fractures. Surgeon attention to dorsal fracture location can help identify displacement patterns and provide guidance in adequately reducing a displaced scaphoid fracture.Level of evidence: III.
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Affiliation(s)
- Anne Eva J Bulstra
- Department of Orthopedic and Trauma Surgery, Flinders Medical Centre, South Australia, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, Australia.,Department of Orthopaedic Surgery, University of Amsterdam, Amsterdam, The Netherlands
| | - Rami M A Al-Dirini
- Medical Devices Research Institute, Flinders University, Adelaide, Australia
| | - Arthur Turow
- Department of Orthopedic and Trauma Surgery, Flinders Medical Centre, South Australia, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | | | - Kimberley Bryant
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Miryam C Obdeijn
- Department of Plastic, Reconstructive and Hand Surgery, University of Amsterdam, Amsterdam, The Netherlands
| | - Job N Doornberg
- Department of Orthopedic and Trauma Surgery, Flinders Medical Centre, South Australia, Australia.,Department of Orthopaedic Surgery, University of Amsterdam, Amsterdam, The Netherlands
| | - Ruurd L Jaarsma
- Department of Orthopedic and Trauma Surgery, Flinders Medical Centre, South Australia, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Gregory I Bain
- Department of Orthopedic and Trauma Surgery, Flinders Medical Centre, South Australia, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, Australia
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