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3D mapping of scaphoid fractures and comminution

Skeletal Radiology volume 49, pages 1633–1647 (2020)Cite this article

Abstract

Objective

Acute and subacute scaphoid fractures were assessed using 3D computer tomography (CT). The aims were to describe fracture morphology, to map fractures onto a 3D scaphoid model and to correlate this to scaphoid anatomy.

Materials and methods

A retrospective, multicentre database search was performed to identify CT studies of acute and subacute scaphoid fractures. CT scans of scaphoid fractures less than 6 weeks from time of injury were included in this retrospective, multicentre study. CTs were segmented and converted into three-dimensional models. Following virtual fracture reduction, fractures were mapped onto a three-dimensional scaphoid model.

Results

Seventy-five CT scans were included. The median delay from injury to CT was 29 days. Most studies were in male patients (89%). Most fractures were comminuted (52%) or displaced (64%). A total of 73% of displaced fractures had concomitant comminution. Waist fractures had higher rates of comminution and displacement when compared with all other fractures. Comminution was located along the dorsal ridge and the volar scaphoid waist.

Conclusion

Our study is the first to describe acute fracture morphology using 3D CT and to correlate comminution and displacement to fracture types. The dorsal ridge and volar waist need prudent assessment, especially in waist fractures.

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Affiliations

  1. Flinders University, Sturt Road, Bedford Park, 5042, South Australia, Australia

    Arthur Turow, Anne Eva Bulstra, Batur Hayat, Job Doornberg, John White, Ruurd L. Jaarsma & Gregory I. Bain

  2. Department of Orthopaedic Surgery, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, 5042, Australia

    Arthur Turow, Job Doornberg, John White, Ruurd L. Jaarsma & Gregory I. Bain

  3. Department of Orthopaedic Surgery, University of Amsterdam, location Academic Medical Center, Amsterdam UMC, Amsterdam, the Netherlands

    Anne Eva Bulstra, Batur Hayat & Job Doornberg

  4. Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, the Netherlands

    Miriam Oldhoff

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  1. Arthur Turow
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Correspondence to Arthur Turow.

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Conflicts of interest and source of funding

A.E.B. has received funding from KNAW van Leersum Foundation and the Marti-Keuning-Eckhardt Foundation in support of their research for or preparation of this work.

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Ethics approval was granted from the Southern Adelaide Clinical Human Research Ethics Committee.

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Arthur Turow and Anne Eva Bulstra are co-first authors.

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Turow, A., Bulstra, A.E., Oldhoff, M. et al. 3D mapping of scaphoid fractures and comminution. Skeletal Radiol 49, 1633–1647 (2020). https://doi.org/10.1007/s00256-020-03457-1

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  • DOI: https://doi.org/10.1007/s00256-020-03457-1

Keywords

  • Scaphoid
  • Acute fractures
  • Classification
  • Computer tomography
  • 3D CT