Abstract
Background Scaphocapitate syndrome is a rare injury where the proximal pole of the capitate
rotates 90 to 180 degrees. The proximal pole of the capitate, thought to receive its
vascular supply retrograde, is rendered avascular in such cases. However, recent evidence
of low rates of avascular necrosis in displaced capitate fractures, and new vascular
studies of the capitate, challenge this paradigm.
Case Description We report a case of a missed and neglected scaphocapitate syndrome with more than
30 years follow-up. While the patient experienced midcarpal arthritis, the injury
had not resulted in capitate proximal pole avascular necrosis as per T1 magnetic resonance
imaging studies.
Literature Review Missed and chronic cases of scaphocapitate syndrome were reported previously. Successful
outcomes were achieved with anatomical reduction in cases without midcarpal arthritis.
Salvage procedures or arthroplasty procedures are recommended with the presence of
midcarpal arthritis. However, there are no reports of a neglected case with more than
30 years follow-up with preserved vascularity of the proximal pole of the capitate.
Clinical Relevance This case illustrates that vascularity of the proximal pole of the capitate can be
preserved even in longstanding displaced fractures.
Keywords
capitate - scaphocapitate syndrome - avascular necrosis - wrist - carpal bones
