Scaphoid fractures and associated ligament injury : five-year follow-up of the SWIFFT trial
Johnson, Nick Francis, Roshni Choudhary, Surabhi Jeyapalan, Kanagaratnam Dias, Joseph J
Johnson, Nick
Francis, Roshni
Choudhary, Surabhi
Jeyapalan, Kanagaratnam
Dias, Joseph J
Abstract
Aims: The association between scaphoid fractures and ligament injuries is uncertain, and the clinical relevance is not well established. The aim of this study was to undertake a secondary analysis of data from the Scaphoid Waist Internal Fixation for Fractures Trial (SWIFFT) to evaluate the incidence of concurrent ligament injuries in patients with a scaphoid waist fracture displaced by ≤ 2 mm, explore the radiological changes between one and five years after the injury, and assess whether there is an association between the characteristics of the fracture and ligament injury.
Methods: All 439 patients from the SWIFFT had baseline measurements available from plain radiographs and CT scans. Further follow-up measurements were undertaken from CT scans in 292 patients at 52 weeks and 239 patients at five years. A total of 345 patients had radiographs suitable for assessment of the scapholunate (SL) and lunotriquetral (LT) intervals at 52 weeks and/or five years.
Results: Only 12 patients (2.8%) had widening of the SL gap by > 3 mm on initial imaging. There was no progression of these gaps at five years, and no patient had widening of the LT gap.
Conclusion: Injury to the interosseous intercarpal ligaments causing diastasis of carpal bones is rare in patients with a scaphoid waist fracture displaced by ≤ 2 mm. Treatment of the fracture with a cast or surgical fixation, without additional imaging or intervention for a potential ligament injury, appears adequate for most fractures. If there are ligament injuries not identified with standard imaging, they do not seem to progress.
MIDER Authors
Date
2026-04-01
Type
Article
Subject
Scaphoid bone, Fractures, bone, Ligaments, Fracture fixation, Casts, surgical
Citation
Johnson NA, Francis R, Choudhary S, Jeyapalan K, Dias JJ. Scaphoid fractures and associated ligament injury : five-year follow-up of the SWIFFT trial. Bone Joint J. 2026 Apr 1;108-B(4):538-543. doi: 10.1302/0301-620X.108B4.BJJ-2025-0876.R1.
Journal / Source Title
The Bone & Joint Journal
DOI
10.1302/0301-620X.108B4.BJJ-2025-0876.R1
PMID
41916572
Publisher
British Editorial Society of Bone & Joint Surgery
Publisher’s URL
https://boneandjoint.org.uk/?journalCode=bjj