{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:46:48Z","timestamp":1772102808762,"version":"3.50.1"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Scaphoid malunion is rarely reported. Previous literature has attributed loss of carpal height and degenerative changes to scaphoid malunion, but the percentage of asymptomatic malunions remains unknown.<\/jats:p><jats:p>\n          Purpose\u2003The authors of this study aim to define predictors of malunion and outcomes associated with scaphoid malunion.<\/jats:p><jats:p>\n          Methods\u2003Institutional board review was obtained prior to evaluating medical records of patients 18 years and older who were treated for scaphoid fractures and\/or nonunion between 2000 and 2020. The following data were collected for each patient: age, gender, fracture location, surgical technique, time to union, and whether malunion resulted. Malunion was defined using a lateral intrascaphoid angle (LISA) &gt;45\u2009degrees and height-to-length ratio (HLR) &gt;60. Pain scores, range of motion (ROM), and secondary surgery were also evaluated.<\/jats:p><jats:p>\n          Results\u2003Overall, 355 scaphoid injuries, including 196 acute fractures and 159 nonunions, were evaluated in this analysis. Of these, 55 scaphoids (15%) met the definition of malunion. Of these patients, 23% were female. The mean age at the time of injury was 29 years. Nonunion cases were more likely than acute cases to be associated with malunion. Proximal pole fractures were more likely to associated with malunion than waist fractures. When controlling for nonunion and fracture location, malunited scaphoids were not associated with any significant difference in pain score, ROM, or secondary surgery, compared with nonmalunion cases. A total of 10 patients (3.3%) without malunion and 2 patients (3.6%) with malunion went on to a secondary surgery. Final extension\/flexion was 67\/67\u2009degrees and 56\/59\u2009degrees in nonmalunion and malunion groups, respectively, but these differences were not significant.<\/jats:p><jats:p>\n          Conclusion\u2003Compared with scaphoid injuries that do not result in malunion, scaphoid injuries that heal into malunion have similar outcomes. While scaphoid malunion in a single case or series may be associated with poor outcomes, this study suggests that scaphoid malunions do not have worse functional outcomes.<\/jats:p><jats:p>\n          Level of Evidence\u2003This is a Level IV study.<\/jats:p>","DOI":"10.1055\/s-0042-1751016","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T22:46:28Z","timestamp":1657147588000},"page":"040-045","source":"Crossref","is-referenced-by-count":4,"title":["Scaphoid Malunion: Incidence, Predictors, and Outcomes"],"prefix":"10.1055","volume":"12","author":[{"given":"Jill","family":"Putnam","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Redwood City, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayla","family":"Pfaff","sequence":"additional","affiliation":[{"name":"Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Yao","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Redwood City, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,7,6]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/0363-5023(89)90191-3","article-title":"Scaphoid malunion","volume":"14","author":"P C Amadio","year":"1989","journal-title":"J Hand Surg Am"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1016\/S0363-5023(87)80067-9","article-title":"The effect of a simulated scaphoid malunion on wrist motion","volume":"12","author":"R C Burgess","year":"1987","journal-title":"J Hand Surg Am"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/S0363-5023(05)80177-7","article-title":"Corrective osteotomy for scaphoid malunion: technique and long-term follow-up evaluation","volume":"22","author":"N M Lynch","year":"1997","journal-title":"J Hand Surg Am"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.injury.2011.08.015","article-title":"Scaphoid morphology and clinical outcomes in scaphoid reconstructions","volume":"43","author":"K Megerle","year":"2012","journal-title":"Injury"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.otsr.2014.09.026","article-title":"Clinical outcome of scaphoid malunion as a result of scaphoid fracture nonunion surgical treatment: a 5-year minimum follow-up study","volume":"101","author":"C H Lee","year":"2015","journal-title":"Orthop Traumatol Surg Res"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1177\/1753193408093327","article-title":"The clinical outcome of scaphoid fracture malunion at 1 year","volume":"34","author":"D P 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scaphoid malunion","volume":"12","author":"B P Gillette","year":"2017","journal-title":"Hand (N Y)"},{"issue":"12","key":"ref14","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1016\/j.injury.2005.09.003","article-title":"Corrective osteotomy for symptomatic scaphoid malunion","volume":"36","author":"E A El-Karef","year":"2005","journal-title":"Injury"},{"issue":"06","key":"ref15","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/S0266-7681(98)80094-6","article-title":"Scaphoid malunion. The significance of rotational malalignment","volume":"23","author":"D L Fern\u00e1ndez","year":"1998","journal-title":"J Hand Surg [Br]"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.jhsa.2005.03.001","article-title":"Both scanning plane and observer affect measurements of scaphoid deformity","volume":"30","author":"D Ring","year":"2005","journal-title":"J Hand Surg Am"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/S0363-5023(98)80093-2","article-title":"Measurement of the scaphoid humpback deformity using longitudinal computed tomography: intra- and interobserver variability using various measurement techniques","volume":"23","author":"G I Bain","year":"1998","journal-title":"J Hand Surg Am"},{"issue":"06","key":"ref18","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s00402-014-1998-4","article-title":"Reliability and validity of carpal alignment measurements in evaluating deformities of scaphoid fractures","volume":"134","author":"Y H Roh","year":"2014","journal-title":"Arch Orthop Trauma Surg"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/S0363-5023(88)80045-5","article-title":"Evaluation of the humpback scaphoid by computed tomography in the longitudinal axial plane of the scaphoid","volume":"13","author":"W E Sanders","year":"1988","journal-title":"J Hand Surg Am"}],"container-title":["Journal of Wrist Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1751016.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:13:18Z","timestamp":1673568798000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1751016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,6]]},"references-count":19,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2023,1,12]]},"published-print":{"date-parts":[[2023,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1751016","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2163-3916","2163-3924"],"issn-type":[{"value":"2163-3916","type":"print"},{"value":"2163-3924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,6]]}}}