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Journal of the Korean Society for Surgery of the Hand 2004;9(1):7-11.
Published online January 1, 2004.
Relationships Between Radiologic Findings and Development of DISI in Scaphoid Nonunions
Min Jong Park, Hee Pyo Jang, Young Min Kim
주상골 불유합의 단순 방사선 소견과 후방 개재 분절 불안정의 상관 관계
박민종, 장희표, 김영민
Abstract
Purpose
We investigated various radiographic parameters, which would designate dorsal intercalated segmental instability(DISI) in simple radiographs of the wrist in the patient with scaphoid fracture nonunion. Materials and Methods: We analyzed simple posteroanterior, lateral, and ulna-deviation postero-anterior views of the wrist in 48 patients with scaphoid fracture nonunion. As parameters of radiographic findings, the distal fragment ratio (ratio of distal fragment length with respect to the total scaphoid length), which indicates location of fracture, slope angle (angle between the vertical line to the axis of the scaphoid and the central line of nonunion), and morphologic types of nonunion (sclerotic, cystic, or mixed) were assessed. These variables were compared and statistically analyzed with the scapholunate angle and radiolunate angle, which are used as parameters of DISI pattern. Results: There was significant relationship between the distal fragment ratio and the scapholunate angle, which indicated tendency toward instability associated with more distal location of a fracture. When the patients were divided into DISI and non-DISI groups, distal fragment ratio was significantly smaller in the DISI group. There was no significant relationship between the slope, and morphologic types and instability. Conclusion: The scaphoid fracture nonunion tends to show DISI as the fracture locates at the more distal portion of the scaphoid. Thus, the location of fracture can be used as an effective finding in predicting instability.
 


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