The role of arthroscopy in the diagnosis of concomitantsoft tissue injuries in scaphoid fractures and the effect ofconcomitant soft tissue injuries and fracture comminutionon outcomes: A case-control study

Abstract

Objectives: This study aims to evaluate the role of arthroscopy inthe diagnosis of concomitant injuries, to investigate the relationshipbetween comminution and concomitant injuries, and to analyze theeffect of concomitant injuries on functional outcomes in acute andsubacute scaphoid fracture. Patients and methods: Between January 2011 andSeptember 2018. A total of 32 acute scaphoid fracturepatients (29 males, 3 females; mean age: 30±12 years;range, 18 to 65 years) were retrospectively analyzed. None of themhad an obvious ligament injury in the radiological assessment.Functional outcomes were compared between concomitantand non-concomitant injuries and between comminuted andnon-comminuted injuries. The percentage of range of motion(ROM), grip, and pinch strength were recorded according to thecontralateral extremity to detect the restriction rate. The MayoWrist Score (MWS), the Turkish version of the Quick Disabilityof the Arm, Shoulder, and Hand (Q-DASH) and Patient-RatedWrist Evaluation (PRWE) questionnaires were used to evaluatethe functional results. Subjective pain was assessed usingthe Visual Analog Scale (VAS). The relationship betweenconcomitant injuries and comminution was investigated. Results: There were 13 patients with comminuted fractures.Concomitant injuries were diagnosed in 17 patients. The presenceof concomitant injuries was higher in comminuted fracturesthan in non-comminuted fractures. There was no significantdifference between the groups in ROMs. The final follow-upQ-DASH, PRWE, MWS, and VAS scores and the pinch strengthof non-comminuted fractures were found to be statistically betterthan those of comminuted fractures. There were statisticallyworse Q-DASH, PRWE, MWS, and VAS scores in patients withconcomitant injuries. Conclusion: Arthroscopic scaphoid fracture surgery allows thediagnosis and treatment of concomitant lesions. The functionaloutcomes of concomitant lesions and comminuted fractures seemto be worse than those of others, while the ROM is comparable.