Diferencia entre revisiones de «Capitate fracture»
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==Management== | ==Management== | ||
{{General Fracture Management}} | |||
===Specific Management=== | |||
*Isolated capitate fracture requires [[forearm volar splint]] immobilization and early ortho referral | *Isolated capitate fracture requires [[forearm volar splint]] immobilization and early ortho referral | ||
*Capitate fracture associated with [[scaphoid fracture]] or dislocations requires surgical treatment | *Capitate fracture associated with [[scaphoid fracture]] or dislocations requires surgical treatment | ||
Revisión actual - 04:49 18 sep 2019
Background
- Isolated capitate fractures are rare (scaphoid is most common associated fracture)
- Occurs via forceful dorsiflexion of hand (FOOSH injury) with impact on radial side
- Proximal fracture fragment at risk for avascular necrosis
Clinical Features
- Diffuse swelling and tenderness over capitate (just proximal to 3rd metacarpal)
Differential Diagnosis
Carpal fractures
- Scaphoid fracture
- Lunate fracture
- Triquetrum fracture
- Pisiform fracture
- Trapezium fracture
- Trapezoid fracture
- Capitate fracture
- Hamate fracture
Evaluation
- Hand x-ray
- Often overlooked due to accompanying scaphoid fracture or lunate/perilunate dislocation
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Specific Management
- Isolated capitate fracture requires forearm volar splint immobilization and early ortho referral
- Capitate fracture associated with scaphoid fracture or dislocations requires surgical treatment
Disposition
- Generally may be dishcarged