Purpose
This study determined the volume of bone replaced by an implant at the proximal and
distal poles of simulated scaphoid fractures. We also measured the cross-sectional
area of the implant relative to the cross-sectional area of the scaphoid at 2 different
simulated fracture locations.
Methods
Microcomputed tomograhy scans of 7 cadaveric scaphoids were used to create 3-dimensional
models in which transverse proximal pole and midwaist fractures were simulated. The
volume occupied by 5 commonly used implants and the cross-sectional area occupied
at the surface of the fractures was measured using a computer modeling software.
Results
For simulated proximal pole fractures, the implants replaced 1.5%–7.4% of the fracture
cross-sectional area and 1.2%–6.4% of the proximal fragment bone volume. For midwaist
fractures, the implants replaced 1.5%–6.8% of the fracture cross-sectional area and
1.8%–4.6% of the proximal pole volume. Although the different implant designs replaced
different areas and volumes, all these differences were small and below 4%.
Conclusions
This study provides data that relate to one aspect of fracture healing, specifically,
the surface area occupied by 5 different implants in proximal and midwaist scaphoid
fractures as well as the volume of bone replaced by the implant.
Clinical relevance
As opposed to the impression provided by 2-dimensional planar imaging, when studied
using a 3-dimensional model, the volume and surface area replaced by an implant represent
a minimal percentage of scaphoid bone, suggesting a negligible clinical effect.
Key words
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References
- Prevalence of carpal fracture in Singapore.J Hand Surg Am. 2011; 36: 278-283
- Fractures of the hand: dstribution and relative incidence.Scand J Plast Reconstr Surg Hand Surg. 1993; 27: 317-319
- Incidence and characteristics of carpal fractures occurring concurrently with distal radius fractures.J Hand Surg Am. 2012; 37: 469-476
- Nonscaphoid carpal injuries—incidence and associated injuries.J Orthop. 2014; 11: 91-95
- Percutaneous fixation of scaphoid fractures.J Am Acad Orthop Surg. 2007; 15: 474-485
- Mechanical evaluation of four internal fixation constructs for scaphoid fractures.Hand (NY). 2016; 11: 72-77
- Stabilization of scaphoid type B2 fractures with one or two headless compression screws.Arch Orthop Trauma Surg. 2017; 137: 1587-1595
- Two-screw fixation of scaphoid waist fractures.J Hand Surg Am. 2020; 45: 783.e1-783.e4
- A systematic review and meta-analysis examining the differences between nonsurgical management and percutaneous fixation of minimally and nondisplaced scaphoid fractures.J Hand Surg Am. 2016; 41: 1135-1144
- Return to sport following scaphoid fractures: a systematic review and meta-analysis.World J Orthop. 18 2019; 10: 101-114
- An epidemiologic perspective on scaphoid fracture treatment and frequency of nonunion surgery in the USA.HSS J. 2018; 14: 245-250
- Geometry of carpal scaphoid in Thais: anatomical study.J Med Assoc Thai. 2003; 86: 457-461
- Anthropometry of the human scaphoid.J Hand Surg Am. 2007; 32: 1005-1008
- Computer-assisted 3-dimensional anthropometry of the scaphoid.Orthopedics. 2010; 33: 85-88
- Quantification of contralateral differences of the scaphoid: a comparison of bone geometry in three dimensions.Anat Res Int. 2014; 2014: 904275
- Central versus eccentric internal fixation of acute scaphoid fractures.J Hand Surg Am. 2013; 38: 66-71
- The vascular anatomy of the scaphoid: new discoveries using micro-computed tomography imaging.J Hand Surg Am. 2019; 44: 928-938
- Ideal starting point and trajectory of a screw for the dorsal approach to scaphoid fractures.J Hand Surg Am. 2018; 43: 993-999
- The impact of scaphoid malunion on radioscaphoid joint contact: a computational analysis.J Hand Surg Am. 2020; 45: 610-618
- Biomechanical analysis of second-generation headless compression screws.Injury. 2012; 43: 1159-1165
- The radiological anatomy of the scaphoid. Part 1: osteology.J Hand Surg Br. 1994; 19: 183-187
- The morphological and morphometric features of the scaphoid.J Hand Surg Br. 2004; 29: 393-398
Article info
Publication history
Published online: December 07, 2021
Accepted:
October 27,
2021
Received:
February 22,
2021
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
