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<p>Carpal coalitions may alter intercarpal kinematics and load transfer. Reported coalition-associated scaphoid fractures show an exclusive predilection for the scaphoid waist, raising the possibility of a non-random biomechanical mechanism with focal stress concentration. These injuries have been associated with delayed union and nonunion. This pattern may justify CT-based assessment and consideration of a lower threshold for early surgical stabilization, including percutaneous screw fixation even in selected nondisplaced waist fractures. However, the currently available evidence is limited to case reports and does not allow firm treatment recommendations. Awareness of coalition anatomy and careful follow-up may be reasonable.</p>

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Scaphoid waist fractures in the presence of carpal coalitions: a consistent biomechanical weak point?

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月26日

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  • Stefanie Schmitt,
  • Dorrit Winterholer,
  • Elmar Fritsche

摘要

Carpal coalitions may alter intercarpal kinematics and load transfer. Reported coalition-associated scaphoid fractures show an exclusive predilection for the scaphoid waist, raising the possibility of a non-random biomechanical mechanism with focal stress concentration. These injuries have been associated with delayed union and nonunion. This pattern may justify CT-based assessment and consideration of a lower threshold for early surgical stabilization, including percutaneous screw fixation even in selected nondisplaced waist fractures. However, the currently available evidence is limited to case reports and does not allow firm treatment recommendations. Awareness of coalition anatomy and careful follow-up may be reasonable.