Normal ranges for measurements of the scaphoid bone from sagittal computed tomography images

Guldbrandsen, Cæcilie W; Radev, Dimitar Ivanov; Gvozdenovic, Robert

doi:10.1177/1753193420987522

Cited by 10 publications

(9 citation statements)

References 22 publications

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“…The H/L ratio median was 0.67 (0.57–0.93) before and 0.66 (0.57–0.76) after reconstruction in the incidence group and slightly higher in the control group with 0.70 (0.55–1.03) and 0.68 (0.55–0.81), respectively. These measurements are in line with a previously published study 8 but did not correlate significantly with postoperative CTS.…”

Section: Resultssupporting

confidence: 92%

Carpal Tunnel Syndrome as a Complication of Surgical Scaphoid Reconstruction in Nonunion and Secondary Fracture Dislocation

Brackertz,

Andronic,

Reissner

et al. 2023

J Wrist Surg

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The purpose of this study was to identify risk factors for postoperative carpal tunnel syndrome (CTS) in operative management for scaphoid nonunion and secondary fracture dislocation, treated surgically with takedown and bone grafting. We reviewed medical records of all our patients that underwent carpal tunnel release after scaphoid reconstruction surgery from August 2002 to December 2020. We identified a total of 7 out of 191 patients (3.7%). We investigated surgical parameters, pre- to postoperative changes, in three-dimensional measurements of the scaphoid and carpal tunnel morphometry. We found the preoperative intrascaphoid angle (ISA) and the postoperative change in ISA to correlate with an increased risk of postoperative CTS. Patients undergoing operative scaphoid reconstruction that require a high degree of geometric correction can be at risk to develop postoperative CTS, hence they should be subject to a lower threshold decision for prophylactic carpal tunnel release. Level of Evidence Level III.

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Section: Resultssupporting

confidence: 92%

Carpal Tunnel Syndrome as a Complication of Surgical Scaphoid Reconstruction in Nonunion and Secondary Fracture Dislocation

Brackertz,

Andronic,

Reissner

et al. 2023

J Wrist Surg

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“…The similarities in the shape of the scaphoid bone in the two wrists of an individual allows the contralateral scaphoid to be used as a good reference (ten Berg et al, 2015a). The mean H/L ratio of an uninjured scaphoid of 0.61 in our study agrees with the mean ratio of 0.58 to 0.61 reported in previous studies (Guldbrandsen et al, 2021;Ring et al, 2005;ten Berg et al, 2015b). Many of the authors in published literature have considered only the injured scaphoid when assessing a deformity and have used a H/L ratio >0.6 as the common cut-off limit for flexion deformity (Forward et al, 2009;Lee et al, 2015).…”

Section: Discussionsupporting

confidence: 93%

“…This has not been helped with the variations in study design and outcomes assessments in the published literature, as well as a lack of consensus on the definition of scaphoid flexion deformity and how to measure it in a reliable and reproducible way (Seltser et al., 2020; Xiao et al., 2021). Comparisons of different scaphoid measurements suggest that the height–length (H/L) ratio is the best measurement for flexion deformity (Bain et al., 1998; Forward et al., 2009; Guldbrandsen et al., 2021).…”

Section: Introductionmentioning

confidence: 99%

Residual flexion deformity after scaphoid nonunion surgery: 7-year follow-up study

Schriever

Wilcke

2022

J Hand Surg Eur Vol

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The clinical implication of a residual flexion deformity following surgery for scaphoid nonunion is unclear. Sixty-three patients who underwent scaphoid nonunion surgery were assessed after a mean of 7 years (range 5–10) to analyse the outcomes based on the presence of residual scaphoid deformity. Primary outcome was Disabilities of the Arm, Shoulder and Hand score. Secondary outcomes were Patient-Rated Wrist Evaluation score, wrist range of motion and strength. Patients were dichotomized to residual deformity or no deformity. Scaphoid deformity was calculated from CT scans based on the median difference between the height–length ratio of the operated versus the uninjured scaphoid. There were no differences between residual deformity ( n = 33) and no deformity ( n = 30) in any outcome variables, except for wrist extension which was slightly worse in the deformity group. The deformity group had a greater number of radiographic osteoarthritis, but all cases were mild, and osteoarthritis did not correlate to a worse outcome. We conclude that residual scaphoid deformity has no relevant negative impact on mid-term wrist function. Level of evidence: IV

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“…However, no consensus on the normal value of LISA has been reached in the literature. [21] Although some studies obtained no satisfactory results in patients treated with NVBG and screw fixation for scaphoid non-unions, recent meta-analyses have shown that, despite a higher union rate and earlier union with the VBG technique, this radiological advantage does not provide any functional benefits. [22,23] Additionally, VBGs are technically more difficult and need more surgical experience.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the functional and radiological outcomes of vascularized and non-vascularized bone graft options in the treatment of scaphoid nonunion

2021

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Objectives This study aims to compare the functional and radiological outcomes of the patients with scaphoid waist nonunion treated with non-vascularized bone graft and vascularized bone graft options. Patients and methods Between January 2016 and February 2020, a total of 24 patients (22 males, 2 females; mean age: 30.6±9.4 years; range, 18 to 66 years) with scaphoid waist nonunion who were treated with vascularized or non-vascularized bone graft were retrospectively analyzed. Of these patients, eight were treated with iliac crest non-vascularized bone graft (IC-NBG), seven with vascularized free medial femoral condyle (MFC) graft, and nine with 1,2-intercompartmental supraretinacular artery pedicled vascularized bone graft (1,2-ICSRA-VBG). The grip strength, flexion, extension, radial deviation, ulnar deviation angles were measured and compared to the contralateral hand for functional outcomes. Union rates, the scaphoid height-to-length ratio, the lateral intrascaphoid angle (LISA) were evaluated for radiological outcomes. The Mayo Wrist Score, Visual Analog Scale (VAS) score, and Quick Disability of the Arm, Shoulder and Hand (Q-DASH) Questionnaire score were calculated. Results Union was observed in seven (87.5%) patients after IC-NBG, in six (85.7%) patients after MFC bone graft and nine (100%) patients in the treatment group with 1,2-ICSRA-VBG. There were no statistically significant differences among the IC-NBG, MFC and 1,2-ICSRA-VBG groups in terms of the union rates, the scaphoid height-to-length ratio, VAS score, Q-DASH score, grip strength and flexion, ulnar deviation, radial deviation angles after surgery (p>0.05). However, extension was statistically lower in the MFC group than IC-NBG and 1,2-ICSRA-VBG groups after surgery. The Mayo score was better in the IC-NBG group than MFC and 1,2-ICSRA-VBG, indicating a statistically significant difference (p<0.05). Conclusion Based on our study results, we suggest to use IC-NBG for scaphoid waist nonunion as the primary procedure, as the union rates are comparable with the MFC and 1,2-ICSRA-VBG techniques and it has advantages such as shorter operation time, easier technique, no special experience requirement, and better functional outcomes.

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Normal ranges for measurements of the scaphoid bone from sagittal computed tomography images

Cited by 10 publications

References 22 publications

Carpal Tunnel Syndrome as a Complication of Surgical Scaphoid Reconstruction in Nonunion and Secondary Fracture Dislocation

Carpal Tunnel Syndrome as a Complication of Surgical Scaphoid Reconstruction in Nonunion and Secondary Fracture Dislocation

Residual flexion deformity after scaphoid nonunion surgery: 7-year follow-up study

Comparison of the functional and radiological outcomes of vascularized and non-vascularized bone graft options in the treatment of scaphoid nonunion

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