Capitate fracture

Background

• Isolated capitate fractures are rare; most often occur along w/ scaphoid fx
• Occurs via forceful dorsiflexion of hand w/ 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)

Imaging

• Standard views
• Often overlooked b/c of accompanying scaphoid fx or perilunate/lunate dislocation

Capitate fracture

Differential Diagnosis

Carpal fractures

AP view

• Scaphoid fracture
• Lunate fracture
• Triquetrum fracture
• Pisiform fracture
• Trapezium fracture
• Trapezoid fracture
• Capitate fracture
• Hamate fracture

Management

• Isolated capitate fracture requires forearm volar splint immobilization and early ortho referral
• Capitate fracture associated w/ scaphoid fracture or dislocations requires surgical treatment

See Also

• Carpal fractures

Source

• Tintinalli