The effects of simulated unstable scaphoid fractures on carpal motion

Smith, Douglas K.; Cooney, William P.; An, Kai Nan; Linscheid, Ronald L.; Chao, Edmund Y.S.

doi:10.1016/0363-5023(89)90022-1

Cited by 80 publications

(51 citation statements)

References 19 publications

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“…Extension occurs through the proximal scaphoid fragment and lunate while flexion occurs through the distal scaphoid fragment resulting in a dorsal fractureg ap. These clinical findings confirm cadaveric biomechanical studies that demonstrate that waist fractures aresubjected to "bending" forces which areresisted by intact scapho-carpal ligaments (37,38,39).…”

Section: Discussionsupporting

confidence: 81%

Retrospective Review of 234 Scaphoid Fractures and Nonunions Treated with Arthroscopy for Union and Complications

Slade

Gillon

2008

Scand J Surg

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the purpose of this paper is to retrospectively review 234 consecutive cases of scaphoid fractures and nonunions treated using arthroscopy with the dorsal percutaneous implantation of ah eadless compression screw for healing and complications. solid union of fracture is determined by ct scan. we identified 126 acute injuries, including 65 proximal pole fractures; 67 grossly displaced fractures; 12 trans-scaphoid perilunate dislocations including four trans-scaphoid trans-capitate fractures; and ten combined scaphoid and distal radius fractures. 108 scaphoid nonunions were identified. 98 were correctly aligned and ten had ah umpback deformity which was correctable using arthroscopic assisted reduction techniques at the time of surgery.8 2p resented with af racture gap 2mm or greater requiring percutaneous bone grafting. 12 cases of avascular necrosis (avn) were identified by mRi. 20 nonunions had surgery performed at other institutions. the mean time to surgery for the nonunions was 20 months.99% union rate of acute scaphoid fractures was obtained by 12 weeks, as determined by ct scan. twoc omplications were identified (3%). one case of delayed healing was identified. this delayed union was treated with percutaneous bone grafting and continued on to heal uneventfully.the other complication was acase of volar trans-scaphoid peri-lunate dislocation. while the fracture healed, the patient developed at raumatic dislocation requiring ac apitate-lunate arthrodesis. tr eatment of scaphoid nonunions resulted in ten cases of delayed healing, which were treated with repeat percutaneous bone grafting. this represented a9 %c omplication rate. of the ten cases of delayed unions that were re-bone grafted, four failed to heal by nine months. this resulted in a 96% union rate of our nonunion group by nine months. when acute fracture healing was compared to nonunions the average healing of acute fractures as determined by ct scanning measuring trabecular bridging was 12 weeks, while the average healing of nonunions was 22 weeks. we conclude that the dorsal percutaneous treatment of scaphoid fractures and nonunions using arthroscopy is safe and effective. ct scans to evaluate scaphoid healing by measuring trabecular bridging at the fracture site was determined to be an excellent modality to evaluate scaphoid healing. while not witnessed in this series, the potential for complications requires proper training.

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Section: Discussionsupporting

confidence: 81%

Retrospective Review of 234 Scaphoid Fractures and Nonunions Treated with Arthroscopy for Union and Complications

Slade

Gillon

2008

Scand J Surg

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“…10). 6 If separated from the lunate, under physiologic load the scaphoid will collapse into a more stable (but less physiologic) position perpendicular to the plane of the palm. The lunate will slide palmar on the distal radius articular surface and extend (Fig.…”

Section: Diagnosis Of Dynamic (Or Pre-dynamic) Sl Instabilitymentioning

confidence: 99%

Physical Examination of the Wrist: Useful Provocative Maneuvers

Kleinman

2015

The Journal of Hand Surgery

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“…Smith et al 9) have concluded that the scaphoid serves an important role in maintaining normal alignment of the carpal bones and in producing normal wrist motion, and Sennwald et al 3) have suggested that the lunate is intercalated both longitudinally and transversely with the adjacent carpal bones. It is hoped that our calculated polynomial expression will serve as a frame of reference in the evaluation of a given mode of physical therapy prescribed for subjects with joint dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…In the wrist joint, accessory movement of the carpal bones occurs against the radius during extension (dorsiflexion) -flexion (palmar-flexion) motion. A number of previous studies have described changes in the patterns of carpal bone movement during wrist motion [2][3][4][5][6][7][8][9][10][11][12][13][14] , some of which have specifically examined the motion of the lunate during wrist extension-flexion [2][3][4] . Moojen et al 2) reviewed the contribution of the scaphoid and the lunate to the inplane motion during flexion-extension of the wrist.…”

Section: Introductionmentioning

confidence: 99%

Accessory Movement of the Lunate during Active Flexion and Extension Motion of the Wrist

2006

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Abstract. This study investigated the accessory movement of the lunate in the volar-dorsal direction during active flexion-extension motion of the wrist. The right wrist of a healthy 50-year-old (right-handed) male was studied using an ultrasound diagnostic instrument to measure the wrist's continuous motion from (neutral to) flexion to extension (back to neutral). An ultrasound system was applied on the dorsal aspect of the subject's wrist over the radiocarpal joint. The distance between the dorsal plane of the radius and that of the lunate was measured in each image. The distance data were depicted on a graph using the method of least squares. The lunate moved 0.5 mm dorsally during flexion, and it moved 1.5 mm in the palmar direction during extension. The variance value of the 5th degree polynomial expression of the curve was 0.147. It is hoped that our polynomial expression in this study will serve as a frame of reference in the evaluation of a given mode of physical therapy prescribed for subjects with joint dysfunction.

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The effects of simulated unstable scaphoid fractures on carpal motion

Cited by 80 publications

References 19 publications

Retrospective Review of 234 Scaphoid Fractures and Nonunions Treated with Arthroscopy for Union and Complications

Retrospective Review of 234 Scaphoid Fractures and Nonunions Treated with Arthroscopy for Union and Complications

Physical Examination of the Wrist: Useful Provocative Maneuvers

Accessory Movement of the Lunate during Active Flexion and Extension Motion of the Wrist

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