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Effects of a scaphoid waist osteotomy on carpal kinematics
Author(s) -
Smith D. K.,
An K. N.,
Cooney W. P.,
Linscheid R. L.,
Chao E. Y.
Publication year - 1989
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.1100070418
Subject(s) - wrist , medicine , ulnar deviation , osteotomy , orthodontics , radiography , carpal bones , deformity , cadaveric spasm , scaphoid fracture , anatomy , surgery
The effects of a scaphoid osteotomy on the kinematics of the carpal bones were determined in five cadaveric wrist specimens. Minute radiographic markers were inserted into the distal radius and selected carpal bones through limited arthrotomies between the intercarpal ligaments. Simultaneous biplanar radiographs were obtained in neutral and the extreme wrist positions of extension, flexion, radial deviation, and ulnar deviation, both before and after a scaphoid waist osteotomy. The positions of each of the carpal markers and their corresponding carpal bones were digitized for each wrist position, and a computer‐assisted motion analysis was performed for each specimen before and after transverse scaphoid waist osteotomy. Following the osteotomy, there was a tendency for the scaphoid osteotomy to collapse into a dorsally angulated or “humpback collapse” deformity during each extreme wrist position. There was also multiplanar osteotomy site motion as well as complex collapse deformities of the midcarpal joint associated with loss of the mechanical tie‐rod function of the scaphoid. These findings reveal the importance of the scaphoid in maintaining normal kinematics and the inherent instability of these fractures with loss of scaphoid integrity.