Scaphoid fracture displacement with forearm rotation in a short-arm thumb spica cast

Citation
Sa. Kaneshiro et al., Scaphoid fracture displacement with forearm rotation in a short-arm thumb spica cast, J HAND S-AM, 24A(5), 1999, pp. 984-991
Citations number
16
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine
Journal title
JOURNAL OF HAND SURGERY-AMERICAN VOLUME
ISSN journal
03635023 → ACNP
Volume
24A
Issue
5
Year of publication
1999
Pages
984 - 991
Database
ISI
SICI code
0363-5023(199909)24A:5<984:SFDWFR>2.0.ZU;2-X
Abstract
Three-dimensional motion between the fragments of an experimental scaphoid waist fracture was measured during dynamic forearm pronation and supination in a short-arm thumb spica cast with and without applied tendon loads. Met al markers placed in each fragment were tracked using high-speed biplane ra diographic image sequences and stereophotogrammetric analysis. Peak displac ements (from the intact state) exceeded 1 mm in all specimens, with the lar gest movements occurring in the radial direction during pronation (mean: 2: 1 mm unloaded, 2.5 mm loaded). Total range of displacement motion between f ragments exceeded 3 mm (mean ulnar/radial direction: 3.4 mm unloaded, 4.1 m m loaded). Dorsal/palmar and proximal/distal displacements were minimal exc ept at the extremes of forearm pronation/supination. Rotations between frag ments were small (within +/-6 degrees) and varied considerably across speci mens. No significant differences were found between loaded and unloaded tri als. Thus, in the absence of long-arm thumb spica casting to limit forearm rotation, significant motion between the fragments of a scaphoid waist frac ture is likely. (J Hand Surg 1999;24A: 984-991. Copyright (C) 1999 by the A merican Society for Surgery of the Hand.)