Correlation of reconstructed scaphoid morphology with clinical outcomes

Scaphoid malunion alters the carpal kinematics and impairs clinical outcome because of pain, weakness,
restricted range of motion and predisposing the wrist joint to early osteoarthritis. The aim of this study was to evaluate
the influence of the scaphoid morphological angles on clinical outcomes in patients with reconstructed scaphoid by nonvascularized
bone graft.
Methods: Seventeen male patients with the mean age of 31.7±3.7 years and mean non-union time of 31.5±14.7 months
were enrolled in this retrospective study. Average follow up was 48.8±9.4 months. At the last follow-up, the patients were
evaluated clinically for pain, wrist range of motion, grip strength, and wrist functional status. They were also evaluated
radiologically by wrist radiographs and computerized tomography (CT). The overall clinical outcomes were evaluated
by the Cooney wrist function score. The morphology of the reconstructed scaphoids was evaluated by the lateral
intrascaphoid angle, antroposterior intrascaphoid angle, dorsal cortical angle, measuring the length (mm), and height-tolength
ratio on CT scan. The radiological measurements were compared against the overall clinical outcomes.
Results: There were 7 excellent, 7 good, 3 fair clinical results. The mean Cooney wrist function score was 83±4. The
mean lateral intrascaphoid angle was 34.8±1.4 degrees, mean antroposterior intrascaphoid angle was 33.4±2.2 degrees,
mean dorsal cortical angle was 158.3±4.8 degrees, mean scaphoid length was 22.1± 0.7 mm, and mean scaphoid heightto-
length ratio was 0.74±0.04. There were no significant statistical correlations between the lateral intrascaphoid angles,
antroposterior intrascaphoid angles, dorsal cortical angles, scaphoid lengths and scaphoid height-to-length ratios and
Cooney wrist scores in the patients.
Conclusion: In the current study, all the patients had some degree of scaphoid malunion; however, the radiological
measurements of the reconstructed scaphoids did not correlate with the clinical outcomes.