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Vol. 59. Issue 3.
Pages 150-156 (May - June 2015)
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Vol. 59. Issue 3.
Pages 150-156 (May - June 2015)
Original Article
DOI: 10.1016/j.recote.2015.03.004
Analysis of ulnar variance as a risk factor for developing scaphoid non-union
Análisis de la varianza cubital como factor de riesgo para el desarrollo de seudoartrosis de escafoides carpiano
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S. Lirola-Palmeroa,
Corresponding author
lirolaserafin@gmail.com

Corresponding author.
, G. Salvà-Collb, F.J. Terrades-Claderaa
a Departamento de Cirugía Ortopédica y Traumatología, Hospital Son Llàtzer, Palma de Mallorca, Spain
b Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Son Espases, Palma de Mallorca, Spain
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Tables (2)
Table 1. Demographic data of the compared groups, expressed as mean±standard deviation (SD). Comparison of conservative treatment duration in both groups with no significant variations (P: 0.884).
Table 2. Comparison of means and standard deviation (SD) of the radiological findings evaluated. Significant differences were observed between groups with regard to the ulnar variance (P: 0.003).
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Abstract
Objective

Ulnar variance may be a risk factor of developing scaphoid non-union.

Methods

A review was made of the posteroanterior wrist radiographs of 95 patients who were diagnosed of scaphoid fracture. All fractures with displacement less than 1mm treated conservatively were included. The ulnar variance was measured in all patients.

Results

Ulnar variance was measured in standard posteroanterior wrist radiographs of 95 patients. Eighteen patients (19%) developed scaphoid nonunion, with a mean value of ulnar variance of −1.34 (±0.85)mm (CI −2.25 to 0.41). Seventy seven patients (81%) healed correctly, and the mean value of ulnar variance was −0.04 (±1.85)mm (CI −0.46 to 0.38). A significant difference was observed in the distribution of ulnar variance (P<0.05). These results remained significant after adjusting for age, with an OR of 0.69 (CI 0.49 to 0.95).

The patients were categorized into two groups: ulnar variance less than −1mm, and ulnar variance greater than −1mm. It appears that patients with ulnar variance less than −1mm had an OR 4.58 (CI 1.51 to 13.89) with P<0.007.

Discussion

Desai et al. concluded that radiological features of acute scaphoid fractures cannot be used to predict the likelihood of fracture union. For this reason, the existence of other risk factors was analyzed.

According to the results of the present study, it can be concluded that patients with scaphoid fracture and ulnar variance less than −1mm have a greater risk of developing scaphoid nonunion, OR 4.58 (CI 1.51 to 13.89) with P<0.007.

Keywords:
Scaphoid
Ulnar variance
Non-union
Resumen
Objetivo

Estudiar la varianza cubital como factor de riesgo en el desarrollo de seudoartrosis de escafoides.

Material y método

Analizamos retrospectivamente las radiografías posteroanterior de muñeca de 95 pacientes diagnosticados de fractura de escafoides. Incluimos todas las fracturas con un desplazamiento menor de 1mm tratadas de forma conservadora. Realizamos la medición de la varianza cubital en todos los pacientes.

Resultados

Dieciocho pacientes (19%) desarrollaron seudoartrosis de escafoides, siendo el valor medio de la varianza cubital −1.34 (±1.85) mm (IC −2.25–0.41). Setenta y siete pacientes (81%) sanaron correctamente y su valor medio de varianza cubital fue −0.04 (±1.85) mm (IC −0.46–0.38). Se observaron diferencias significativas en la distribución de la varianza cubital (P<0.05). Este resultado se mantuvo significativo ajustando por edad, con una OR de 0.69 (IC 0,49–0,95).

Categorizamos los pacientes en 2 grupos: varianza cubital menor de −1mm y varianza cubital mayor de −1mm. Los pacientes con varianza cubital menor de −1mm presentaban una OR 4.58 (IC 1.51–1389) con P<0,007.

Discusión

Desai et al. concluyeron que los hallazgos radiológicos en la fractura de escafoides no pueden predecir la probabilidad de unión de la fractura. Por esta razón, analizamos la existencia de otros factores de riesgo.

Según nuestros resultados, podemos concluir que los pacientes con fractura de escafoides y varianza cubital menor de −1mm tienen mayor riesgo de desarrollo de seudoartrosis de escafoides, OR 4.48 (IC 1.51–1389).

Palabras clave:
Escafoides
Varianza cubital
Seudoartrosis

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