Association between lunate morphology and carpal collapse patterns in scaphoid nonunions. 2007

Steven C Haase, and Richard A Berger, and Alexander Y Shin
Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA. shaase@med.umich.edu

OBJECTIVE Type I lunates have a single distal facet for articulation with the capitate; type II lunates have an additional (medial) hamate facet on the distal articular surface. We retrospectively reviewed a series of patients with scaphoid nonunions to determine if there was an association between lunate morphology and the degree of carpal instability observed. Association between lunate morphology and the location of the scaphoid fracture (proximal or waist) was also investigated. METHODS Radiographs were evaluated for 45 patients with established scaphoid nonunions. Lunate morphology, scaphoid fracture location, and radiolunate angle were determined. RESULTS Type I lunates were present in 21 patients. Of these, 15 were found to have a dorsal intercalated segment instability pattern (radiolunate angle greater than 15 degrees ). By contrast, only 4 of the patients with type II lunates exhibited this pattern of instability. No significant association was found between lunate morphology and the scaphoid fracture location. CONCLUSIONS Type II lunate morphology is associated with significantly decreased incidence of dorsal intercalated segment instability (DISI) deformity in cases of established scaphoid nonunion (p = .0002). Lunate morphology, however, was not significantly associated with the location of the scaphoid fracture in these cases (p = .19).

UI MeSH Term Description Entries
D007593 Joint Instability Lack of stability of a joint or joint prosthesis. Hypermobility, Joint,Instability, Joint,Laxity, Joint,Hypermobilities, Joint,Instabilities, Joint,Joint Hypermobilities,Joint Hypermobility,Joint Instabilities,Joint Laxities,Joint Laxity,Laxities, Joint
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D005260 Female Females
D005599 Fractures, Ununited A fracture in which union fails to occur, the ends of the bone becoming rounded and eburnated, and a false joint occurs. (Stedman, 25th ed) Fracture, Ununited,Ununited Fracture,Ununited Fractures
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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