Radiological and anatomical study to investigate possibility of relationship between scaphoid fracture and lunate morphology.

ABSTRACT

BACKGROUND: A connection between lunate type has been described for medical conditions like Kienbock's disease as well as for wrist osteoarthritis, e.g. STT osteoarthritis. Aim of the Study to investigate the possibility of a relationship between lunate type and the type of wrist injury mainly localised to the scaphoid bone. MATERIAL AND METHODS: 394 PA and lateral radiographs of the wrist (n = 394) were subjected to a detailed assessment by two independent surgeons. The X-rays were selected and analyzed from a computer and archive database run by St. Hedwig Hospital in Trzebnica, from the beginning of January 2011 till the end of December 2012. Most of the X-rays (69%) were obtained from citizens of Trzebnica District. In addition, detailed anatomical studies of the wrist bones were carried out on 20 human preparations fixed in ethanol. RESULTS: Lunate type I was found in 288 wrist radiographs (73%) and type II in the remaining 106 photos (27%). Various types of wrist injuries were diagnosed in 129 cases. These were mainly distal radius fractures, scaphoid fractures and isolated scapholunate instability. There exists a statistically confirmed relationship between scaphoid fracture and lunate type II as well as a connection between lunate type and gender. Anatomical examination of 20 wrists showed the presence of lunate type I in 11 cases and type I in 9 cases. CONCLUSION: 1. Lunate type II is more frequently encountered in men. 2. Scaphoid fractures are more common with lunate type II. 3. The joint surface for the hamate in lunate type II is 2-7 mm in width. 4. The presence of another articular surface for the hamate in lunate type II may contribute to the formation of degenerative changes in the lunohamate joint.