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J Wrist Surg 2015; 04(03): 174-178
DOI: 10.1055/s-0035-1549290
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Scaphocapitate Fracture: Two Cases with Follow-Up over 5 Years

Zoe H. Dailiana
1   Department of Orthopaedic Surgery and Musculoskeletal Trauma, Faculty of Medicine, University of Thessalia, Larissa, Greece
,
Loukia K. Papatheodorou
1   Department of Orthopaedic Surgery and Musculoskeletal Trauma, Faculty of Medicine, University of Thessalia, Larissa, Greece
,
Konstantinos N. Malizos
1   Department of Orthopaedic Surgery and Musculoskeletal Trauma, Faculty of Medicine, University of Thessalia, Larissa, Greece
› Author Affiliations
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Publication History

Publication Date:
07 August 2015 (online)

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Abstract

Background Combined scaphoid and capitate fractures of the wrist are rare entities, and delayed diagnosis is frequent. Scaphocapitate fractures may be associated with reversal of the capitate head 90° or 180° (Fenton syndrome). Different treatment options have been proposed, with variable results.

Case Description We report two cases of scaphocapitate fractures of the wrist, diagnosed 3 and 15 days after the injury. The first patient suffered from Fenton syndrome, a combined displaced fracture of the waist of the scaphoid with 180° reversal of capitate head. The second patient had combined fractures of the scaphoid, capitate, and distal radius. In both our cases, anatomic reduction and internal fixation were achieved, resulting in union of all fractures. The long-term results, after 5.5 and 7 years respectively, were very satisfactory, both clinically and radiographically, without signs of avascular necrosis of the head of the capitate or the scaphoid.

Literature Review Few reports of scaphocapitate fractures were found in literature. Mechanism of injury, treatment, and outcomes of the reported cases in correlation to our cases are discussed.

Clinical Relevance Given the high rate of complications of scaphocapitate fractures, long-term follow-up is important to assess the natural history of the wrist joint after such injuries. The restoration of normal anatomic relationships can lead to a successful long-term functional outcome despite the severity of the injury.

Keywords

capitate fracture - Fenton syndrome - scaphocapitate fracture syndrome - scaphoid fracture - wrist fracture-dislocation
 

  • References

  • 1 Fenton RL. The naviculo-capitate fracture syndrome. J Bone Joint Surg Am 1956; 38-A (3) 681-684
    PubMedGoogle Scholar
  • 2 Monahan PR, Galasko CS. The scapho-capitate fracture syndrome. A mechanism of injury. J Bone Joint Surg Br 1972; 54 (1) 122-124
    PubMedGoogle Scholar
  • 3 Jones GB. An unusual fracture-dislocation of the carpus. J Bone Joint Surg Br 1955; 37-B (1) 146-147
    PubMedGoogle Scholar
  • 4 Pandit R. Proximal and palmar dislocation of the lunate and proximal scaphoid as a unit in a case of scaphocapitate syndrome. A 32-month follow-up. J Hand Surg [Br] 1998; 23 (2) 266-268
    PubMedGoogle Scholar
  • 5 Stein F, Siegel MW. Naviculocapitate fracture syndrome. A case report: new thoughts on the mechanism of injury. J Bone Joint Surg Am 1969; 51 (2) 391-395
    PubMedGoogle Scholar
  • 6 Vance RM, Gelberman RH, Evans EF. Scaphocapitate fractures. Patterns of dislocation, mechanisms of injury, and preliminary results of treatment. J Bone Joint Surg Am 1980; 62 (2) 271-276
    PubMedGoogle Scholar
  • 7 Andreasi A, Coppo M, Danda F. Trans-scapho-capitate perilunar dislocation of the carpus. Ital J Orthop Traumatol 1986; 12 (4) 461-466
    PubMedGoogle Scholar
  • 8 Meyers MH, Wells R, Harvey Jr JP. Naviculo-capitate fracture syndrome. Review of the literature and a case report. J Bone Joint Surg Am 1971; 53 (7) 1383-1386
    PubMedGoogle Scholar
  • 9 Kumar A, Thomas AP. Scapho-capitate fracture syndrome. A case report. Acta Orthop Belg 2001; 67 (2) 185-189
    PubMedGoogle Scholar
  • 10 Adkison JW, Chapman MW. Treatment of acute lunate and perilunate dislocations. Clin Orthop Relat Res 1982; (164) 199-207
    PubMedGoogle Scholar