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Capitate Fracture

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Other Names

  • Scaphocapitate syndrome

Background


Pathophysiology

  • Mechanism of injury is debated, proposed mechanisms include
    • Direct axial load down the third metacarpal base from fall onto extended wrist in ulnar deviation
  • Transverse body fractures are most common
  • Frequently co-occur with[1]
  • Scaphocapitate syndrome
    • Rare presentation where proximal capitate fragment rotates 180° in the sagittal plane [2]

Risk Factors

  • Unknown

Differential Diagnosis

Carpal Bone Fractures

Differential Diagnosis Wrist Pain


Clinical Features


Evaluation

Radiographs

CT, MRI

  • Consider to further evaluate fracture pattern, surgical planning and soft tissue injuries

Classification

  • Transverse pole
  • Transverse body
  • Verticofrontal
  • Parasagittal fractures

Management

Nonoperative

Operative

  • Indications
    • Capitate head fractures due to high risk of nonunion
    • Capitate neck fractures
    • Nondisplaced fractures

Return to Play

  • Physician discretion depending on surgical management
  • Minimum 4-6 weeks

Complications

  • Nonunion
  • Malunion
  • Carpometacarpal Arthritis
  • Avascular necrosis

See Also


References

  1. Suh, Nina, Eugene T. Ek, and Scott W. Wolfe. "Carpal fractures." The Journal of hand surgery 39.4 (2014): 785-791.
  2. Monahan PR, Galasko CS. The scapho-capitate fracture syndrome: a mechanism of injury. J Bone Joint Surg Br. 1972;54(1):122e124.
Created by:
John Kiel on 18 June 2019 22:56:29
Authors:
Last edited:
13 October 2022 21:43:23
Categories:
Trauma | Osteology | Wrist | Upper Extremity | Fractures | Acute