Arthroscopic Treatment of Capitate Nonunion: A New Technique

Abstract

Isolated fractures of the capitate are very rare which means that their nonunion is even rarer. Repair techniques have always been performed by open surgery which may result in loss of mobility due to the capsulotomy. The typically used surgical techniques such as arthrodesis of the carpal or wrist bones can have irreversible consequences on range of motion. No arthroscopic technique has ever been described for this condition. Here, we describe a case of isolated capitate nonunion without ligament tears or other carpal fractures in a 21-year-old male, following a capitate fracture 10 years prior. We describe our arthroscopic treatment technique for this capitate nonunion.

Keywords

wrist surgery - arthroscopy - capitate nonunion - bone graft

Publication History

Received: 15 February 2021

Accepted: 08 June 2021

Article published online:
19 July 2021

• References

• 1 Rand JA, Linscheid RL, Dobyns JH. Capitate fractures: a long-term follow-up. Clin Orthop Relat Res 1982; (165) 209-216
• 2 Sabat D, Arora S, Dhal A. Isolated capitate fracture with dorsal dislocation of proximal pole: a case report. Hand (N Y) 2011; 6 (03) 333-336
• 3 Apostolides JG, Lifchez SD, Christy MR. Complex and rare fracture patterns in perilunate dislocations. Hand (N Y) 2011; 6 (03) 287-294
• 4 Kadar A, Morsy M, Sur Y-J, Akdag O, Moran SL. Capitate fractures: a review of 53 patients. J Hand Surg Am 2016; 41 (10) e359-e366
• 5 Gelberman RH, Gross MS. The vascularity of the wrist. Identification of arterial patterns at risk. Clin Orthop Relat Res 1986; (202) 40-49
• 6 Freedman DM, Botte MJ, Gelberman RH. Vascularity of the carpus. Clin Orthop Relat Res 2001; (383) 47-59
• 7 Yoshihara M, Sakai A, Toba N, Okimoto N, Shimokobe T, Nakamura T. Nonunion of the isolated capitate waist fracture. J Orthop Sci 2002; 7 (05) 578-580
• 8 Freeman BH, Hay EL. Nonunion of the capitate: a case report. J Hand Surg Am 1985; 10 (02) 187-190
• 9 Chahidi N, Rousié M. Spontaneous flexor tendon rupture secondary to capitate non-union. A case report and review of literature. Hand Surg Rehabil 2016; 35 (04) 292-295
• 10 Rico ÁA, Holguin PH, Martin JG. Pseudarthrosis of the capitate. J Hand Surg [Br] 1999; 24 (03) 382-384
• 11 Minami M, Yamazaki J, Chisaka N, Kato S, Ogino T, Minami A. Nonunion of the capitate. J Hand Surg Am 1987; 12 (06) 1089-1091
• 12 Morisawa Y, Ikegami H, Takayama S, Toyama Y. A case of pseudarthrosis of the capitate. Hand Surg 2003; 8 (01) 137-140
• 13 Oh W-T, Kang H-J, Chun Y-M, Koh I-H, Lee Y-J, Choi Y-R. Retrospective comparative outcomes analysis of arthroscopic versus open bone graft and fixation for unstable scaphoid nonunions. Arthroscopy 2018; 34 (10) 2810-2818
• 14 Engel H, Xiong L, Heffinger C, Kneser U, Hirche C. Comparative outcome analysis of internal screw fixation and Kirschner wire fixation in the treatment of scaphoid nonunion. J Plast Reconstr Aesthet Surg 2020; 73 (09) 1675-1682
• 15 Ammori MB, Elvey M, Mahmoud SS. et al; British Society for Surgery of the Hand Scaphoid Nonunion Group. The outcome of bone graft surgery for nonunion of fractures of the scaphoid. J Hand Surg Eur Vol 2019; 44 (07) 676-684
• 16 Asmus A, Lautenbach M, Schacher B, Kim S, Eisenschenk A. [Scaphoid pseudarthrosis : Indications for avascular iliac crest or radius bone grafts]. Orthopade 2016; 45 (11) 951-965
• 17 Kim JK, Yoon JO, Baek H. Corticocancellous bone graft vs cancellous bone graft for the management of unstable scaphoid nonunion. Orthop Traumatol Surg Res 2018; 104 (01) 115-120