Correlation of Reconstructed Scaphoid Morphology with Clinical Outcomes

Abstract

<br/><span style="font-size: xx-small;">Background: </span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Scaphoid malunion alters the carpal kinematics and impairs clinical outcome because of pain, weakness, restricted range of motion and predisposing the wrist joint to early osteoarthritis. The aim of this study was to evaluate </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">the influence of the scaphoid morphological angles on clinical outcomes in patients with reconstructed scaphoid by non-</span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">vascularized bone graft. </span></span><br/><span style="font-size: xx-small;">Methods: </span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Seventeen male patients with the mean age of 31.7±3.7 years and mean non-union time of 31.5±14.7 months were enrolled in this retrospective study. Average follow up was 48.8±9.4 months. At the last follow-up, the patients were </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">evaluated clinically for pain, wrist range of motion, grip strength, and wrist functional status. They were also evaluated radiologically by wrist radiographs and computerized tomography (CT). The overall clinical outcomes were evaluated by the Cooney wrist function score. The morphology of the reconstructed scaphoids was evaluated by the lateral </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">intrascaphoid angle, antroposterior intrascaphoid angle, dorsal cortical angle, measuring the length (mm), and height-to-</span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">length ratio on CT scan. The radiological measurements were compared against the overall clinical outcomes. </span></span><br/><span style="font-size: xx-small;">Results: </span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">There were 7 excellent, 7 good, 3 fair clinical results. The mean Cooney wrist function score was 83±4. The mean lateral intrascaphoid angle was 34.8±1.4 degrees, mean antroposterior intrascaphoid angle was 33.4±2.2 degrees, mean dorsal cortical angle was 158.3±4.8 degrees, mean scaphoid length was 22.1± 0.7 mm, and mean scaphoid height-to-length ratio was 0.74±0.04. There were no significant statistical correlations between the lateral intrascaphoid angles, antroposterior intrascaphoid angles, dorsal cortical angles, scaphoid lengths and scaphoid height-to-length ratios and </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Cooney wrist scores in the patients. </span></span><br/><span style="font-size: xx-small;">Conclusion: </span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">In the current study, all the patients had some degree of scaphoid malunion; however, the radiological measurements of the reconstructed scaphoids did not correlate with the clinical outcomes. </span></span>