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Objective: To investigate the impact of dorsally angulated malunited distal radius fractures on the stability of the radiocarpal joint., Methods: Eight fresh upper limb specimens from 4 human cadavers were obtained, in which radial osteotomy was performed to prepare models of Frykman I distal radius fracture. Pressure-sensitive film was applied to study the changes in the contact area distribution and the pressure load across the radiocarpal joint in response to palmar tilt variation, and the lateral radiograph of the wrist was taken at the end of pressure loading., Results: When the dorsal tilt exceeded 10 degrees, the radioscaphoid and radiolunate articular contact areas were markedly decreased (P<0.01) and shifted to the dorsal aspect of the radiocarpal joint, where the pressure load was significantly increased (P<0.01). A dorsal radiocarpal subluxation was liable to occur on the sagittal plane when the dorsal tilt exceeded 40 degrees., Conclusion: A dorsal tilt over 10 degrees is the most primary cause of radiocarpal instability after a dorsal deformity due to distal radius fractures.

Scaphoid fracture is the most common carpal fracture, accounting for 50%-80% of all carpal fractures in the Youngers and manual workers. The nonunion rate of scaphoid fractures was approximately 10-15%. Scaphoid nonunion can lead to wrist deformity, wrist collapse, ischemic necrosis, and traumatic osteoarthritis resulting in the loss of wrist function and seriously influence the patients' lives. Achieving bony union is essential for the treatment of scaphoid nonunion. Although many surgical procedures including various forms of bone grafting have been developed to improve bony union, there is no conclusion about which method is the most effective and optimal. In this review, we provide an overview of the diagnostic, classification and progress in the treatments of scaphoid nonunion fractures. [ABSTRACT FROM AUTHOR]