Scaphoid fractures are very common injuries that can have serious sequelae if pathologic healing ensues. Although there is consensus regarding the importance of a non-united scaphoid, the impact of a malunited scaphoid is less clear. This is based on a paucity in the literature and understanding of the natural history of scaphoid malunion. This study aims to elucidate this study but investigating the impact of scaphoid malunion and joint kinetics, as well as the impact of scaphoid malunion on carpal bone kinematics. This was accomplished using a combination of in-silico, as well as in-vivo modelling based of cadaveric results derived from an active motion. Our results showed that increasing scaphoid malunion was associated with increasing joint contact at the radioscaphoid joint. There was no significant relationship between scaphoid motion and scaphoid malunion severity, however, there was a significant change in lunate motion, as well as motion between the scaphoid and lunate (p<​0.05).

This work serves as the framework for understanding the complex motion of the carpus and emphasizes the potential importance of establishing a good reduction of the scaphoid following fracture. The clinical importance of this finding has yet to be elucidated, but by understanding this relationship future clinical studies can be target at identifying feature of patients who may benefit from therapy.