A Unique Presentation of Scaphocapitate Syndrome With Extrusion Into the Carpal Tunnel: A Case Report

Akinleye, Sheriff D.; Melamed, Eitan

doi:10.1177/1558944718799461

Cited by 2 publications

(3 citation statements)

References 17 publications

(41 reference statements)

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“…This injury is defined as combination of a scaphoid fracture and a capiate fracture which was reported as a unique form of carpal bone injury. [ 7 ] Our case is similar to scaphocapitate syndrome, but it also had hamate dislocation, which were different from scaphocapitate syndrome.…”

Section: Discussionmentioning

confidence: 67%

Pancarpal dissociation, a very rare type of injury

et al. 2022

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Rationale:Pan-carpal dissociation is very rare injury and there is little information as to diagnosis, treatment, and prognosis of this injury.Patient concerns:A 35-year-man presented to our hospital with severe pain and swelling of the left wrist and forearm after slipping and falling while riding a motorcycle.Diagnosis:The wrist simple radiographs demonstrated unrecognizable severe fracture-dislocation of the carpal bones concomitant with fractures of the radioulnar shaft. Three-dimensional computed tomography revealed a capitate fracture-dislocation, as well as hamate dislocation, lunotriquetral (LT), and scapholunate (SL) dissociation. These findings suggested pan-carpal dissociation.Interventions:To prevent compartment syndrome, fasciotomy, carpal tunnel release, and open reduction and plate fixation for both bone fracture were performed first. Then, for pan-carpal dissociation, the capitate, carpometacarpal joint (CMCJ), and hamate were reduced and fixed first. Then, the SL, LT, and other intercarpal ligaments were repaired. Finally, additional trans-carpal pins to reinforce the ligament repair and 2.0 mm plate to buttress the third CMCJ were fixed. The patient was instructed to begin gentle range of motion exercises of the wrist with pins from four weeks after surgery and all pins were removed at six weeks postoperatively.Outcomes:12 months after the operation, the patient exhibited almost full range of motion with mild pain with VAS (Visual analogue scale) 1–2 at rest and VAS 3–4 with effort. Quick DASH (the disabilities of the arm, shoulder and hand) score was 25 and modified Mayo score was 70. The radiographs demonstrated union of the radioulnar shaft, and the carpal bone alignment was successfully maintainedLessons:Pan-carpal dissociation can be diagnosed in patients with capitate fracture-dislocation, hamate dislocation, LT, and SL dissociation. This pattern of injury is very rare and the authors recommend reduction and fixation of the distal carpal row, followed by the proximal row to facilitate an easy approach to the distal carpal row. Although it is very severe injury, rigid anatomical fixation and an early rehabilitation can lead to favorable functional outcomes.

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Section: Discussionmentioning

confidence: 67%

Pancarpal dissociation, a very rare type of injury

et al. 2022

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“…It was first described by Fenton in 1965 and is recognized as a distinct type of instability of the perilunate. Any injury will disrupt both the scaphoid and capitate bones, which creates a greater arc pattern seen in carpal bone injuries [ 2 ]. The exact incidence of scaphocapitate fracture syndrome is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…The scaphocapitate fracture is a rare injury pattern that occurs due to high-force trauma to the carpus [ 1 ]. Scaphocapitate fractures are scaphoid and capitate fractures with rotation of the capitate’s proximal component through 90 or 180 degrees [ 2 ]. The uncommon incidence of this syndrome may explain the late diagnosis and maltreatment of such cases [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

A unique scaphocapitate fracture syndrome in an adolescent: a case report and a review of literature from the last decade

Mortada

AlKhudhair

Alsaygh

et al. 2022

Journal of Surgical Case Reports

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Scaphocaptiate fracture syndrome is a unique condition and is challenging to manage. This rare fracture develops after high-energy wrist trauma. We reported a patient with a history of falling on an outstretched hand. A 15-year-old boy had scaphocapitate fracture syndrome, which included a displaced fracture of the capitate, an avulsion fracture at the distal tubercle of the scaphoid bone with an extension to the articular surface, and a perilunate fracture. A few months after open reduction and internal fixation were performed, the patient had a satisfying outcome. In addition, we have conducted a review of the literature regarding the mechanism of injury, diagnosis and outcome of published cases in correlation to our discussed case.

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A Unique Presentation of Scaphocapitate Syndrome With Extrusion Into the Carpal Tunnel: A Case Report

Abstract: Volar dislocation of the proximal capitate into the carpal tunnel in scaphocapitate syndrome presents a unique challenge that can be addressed with a combined volar and dorsal approach.

Cited by 2 publications

References 17 publications

Pancarpal dissociation, a very rare type of injury

Pancarpal dissociation, a very rare type of injury

A unique scaphocapitate fracture syndrome in an adolescent: a case report and a review of literature from the last decade

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