Os capitatum Fraktur

Capitate fractures are an uncommon carpal fracture. They rarely occur in isolation and are often associated with greater arc injuries.

Epidemiology

Capitate fractures account for 1-2% of all carpal fractures . It is the second most common carpal bone injury in children .

Pathology

Capitate fractures are most commonly due to high-energy, hyperextension forces .

Radiographic features

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 .

Like the scaphoid, there is a risk of avascular necrosis at the proximal pole given its poor vascularity due to a retrograde blood supply .

Complications

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 , 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.

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