Figure 2

Midcarpal malalignment across the two columns of the wrist; the proximal carpal row does not realign to the angulated radius in the pattern of a row but in a columnar manner. a/ middle column of the wrist comprising of radius, lunate and the capitate demonstrates adaptive angulation at the midcarpal level while, b/ the lateral column comprising of radius, scaphoid and the trapezium, trapezoid shows adaptive angulation at the radio-carpal level. Note, all fractures with both the patterns of carpal malalignment maintain the normal RSA since scaphoid is never seen to rotate with the fracture fragment.