THE ANATOMY OF ACUTE SCAPHOID FRACTURES - A 3-DIMENSIONAL ANALYSIS OFPATTERNS

Various classifications of scaphoid fractures have been based on plain radiography, but there are difficulties in defining the actual fractu re line without an appreciation of the three-dimensional anatomy. Radi ological fracture lines were therefore mapped on transparent methylmet hacrylate models of the bone, An analysis of 91 acute fractures showed that 11 were apparently incomplete. The other 80 showed three basic a natomical patterns: transverse through the waist, oblique in the plane of the dorsal sulcus, or of the proximal pole. There was some variati on and comminution in these patterns, but no distal fractures of the b ody were seen, The interpretation of different radiological projection s is discussed, The findings have implications for the management and the assessment of outcome.