Capitate fracture
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Background
- Isolated capitate fractures are rare; most often occur along with scaphoid fracture
- Occurs via forceful dorsiflexion of hand 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)
Imaging
- Standard views
- Often overlooked b/c of accompanying scaphoid fracture or perilunate/lunate dislocation
Differential Diagnosis
Carpal fractures
- 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 with scaphoid fracture or dislocations requires surgical treatment