Factors Associated With Arthroscopically Determined Scaphoid Fracture Displacement and Instability

PurposeTo identify factors associated with arthroscopically diagnosed scaphoid fracture displacement and instability.MethodsThis was a secondary use of data from 2 prospective cohort studies. The studies included 58 consecutive adult patients with a scaphoid fracture who elected arthroscopy-assisted operative fracture treatment: some for displacement, some as part of a prospective protocol, and others to avoid a cast. All patients had preoperative computed tomography with reconstructions in planes defined by the long axis of the scaphoid.ResultsArthroscopy revealed 38 unstable fractures (movement between fracture fragments; 66%), 27 of which were also displaced. All arthroscopically determined displaced fractures were unstable, and 11 of the 31 arthroscopically determined, nondisplaced fractures were unstable. There was a significant correlation between radiographic comminution (more than 2 fracture fragments) and arthroscopically determined displacement and instability.ConclusionsRadiographic comminution is associated with displacement and instability as determined by arthroscopy.Type of study/level of evidencePrognostic II.