Capitate fractures are an uncommon carpal fracture. They rarely occur in isolation and are often associated with greater arc injuries.
Capitate fractures account for 1-2% of all carpal fractures 1,2. It is the second most common carpal bone injury in children 1.
Capitate fractures are most commonly due to high-energy, hyperextension forces 2.
Capitate fractures will rarely occur in isolation, they can be subtle due to boney overlap, and are most commonly transverse body fractures. These can be subtle on projectional radiography and best appreciated on cross-sectional imaging
Treatment and prognosis
In general, conservative management is warranted for fractures that are non-displaced, fractures that display a high level of displacement require surgical fixation 1.
Like the scaphoid, there is a risk of avascular necrosis at the proximal pole given its poor vascularity due to a retrograde blood supply 1,2.
In very rare circumstances, during a scaphoid and capitate fracture, the proximal aspect of the capitate can rotate 90 degrees into the sagittal plane, this is known as scaphocapitate syndrome 3, which could be better described as a trans-scaphoid, trans-capitate peri-lunar fracture-dislocation that reduces to result in an inversion of the proximal aspect of the capitate.
- 1. Kadar A, Morsy M, Sur YJ, Akdag O, Moran SL. Capitate Fractures: A Review of 53 Patients. (2016) The Journal of hand surgery. 41 (10): e359-e366. doi:10.1016/j.jhsa.2016.07.099 - Pubmed
- 2. Rathachai Kaewlai, Laura L. Avery, Ashwin V. Asrani, Hani H. Abujudeh, Richard Sacknoff, Robert A. Novelline. Multidetector CT of Carpal Injuries: Anatomy, Fractures, and Fracture-Dislocations1. (2008) RadioGraphics. 28 (6): 1771-84. doi:10.1148/rg.286085511 - Pubmed
- 3. E. APERGIS, S. DARMANIS, G. KASTANIS, A. PAPANIKOLAOU. Does the Term Scaphocapitate Syndrome Need to be Revised? A Report of 6 Cases:. (2016) Journal of Hand Surgery. 26 (5): 441-5. doi:10.1054/jhsb.2001.0589 - Pubmed
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