Avascular necrosis of the capitate: report of six cases and review of the literature

Peters, Sebastian J.; Degreef, Ilse; Smet, Luc De

doi:10.1177/1753193414524876

Cited by 31 publications

(38 citation statements)

References 41 publications

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“…Medical condition like gout, ligament instability, hematological disorders, systemic lupus erythematosus, and Gaucher's disease has a contributing effect, along with a history of local or systemic steroid use, smoking, and alcoholism. 3 Initial radiographs show sclerosis of the capitate; the collapse of the capitate head occurs early leading to decrease in the midcarpal joint space. The diagnosis is confirmed by MRI, which has a sensitivity of 95% and can show changes before radiographs.…”

Section: Discussionmentioning

confidence: 99%

Mid-Carpal Joint Sparing Procedure for Idiopathic Avascular Necrosis of Capitate

Ansari

Janardhanan

2020

J Wrist Surg

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Background Avascular necrosis of the capitate (AVNC) is an uncommon pathology of the wrist. Several procedures have been described for the treatment of AVNC. The type of treatment varies depending upon the stages. In early stages, revascularization procedures are performed. If secondary osteoarthritis develops, then the treatment options include intercarpal fusion, four corner fusion, prosthesis replacement of the capitate, tendon interposition, and wrist arthrodesis. No long-term study is available for choosing an appropriate method of the treatment for AVNC. Case Description Herein, we report a case of AVNC that was managed by hemi-resection of the capitate with capito-hamate fusion and tendon interposition. One year after surgery, patient was asymptomatic and radiographs revealed fusion of capito-hamate joint and maintenance of the mid-carpal joint space. There was no evidence of carpal collapse. Literature Review All the literature about mid-carpal joint sparing (MCJS) procedures has been reviewed in this report. This is a goal behind writing of this case report as there have been very few publications about these procedures. Clinical Relevance This case illustrates the successful treatment of AVNC by MCJS procedure. The intercarpal fusion and the four corner fusion are one time procedures, and these can be used if the MCJS procedure fails or sometimes, as primary procedure, if the patient gives consent for the same. It appears prudent to save arthrodesis procedures for the future.

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Section: Discussionmentioning

confidence: 99%

Mid-Carpal Joint Sparing Procedure for Idiopathic Avascular Necrosis of Capitate

Ansari

Janardhanan

2020

J Wrist Surg

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“…The rare condition of osteonecrosis of the capitate bone typically manifests at the capitate head. 44,45 Like the lunate and scaphoid bone, the capitate receives its blood supply from nutrient vessels that have retrograde intraosseous courses after entering at the distal pole. Therefore, like the proximal segments of other carpalia, the capitate head is at particular risk of ischemia and subsequent necrosis.…”

Section: Osteonecrosis Of the Capitate Bonementioning

confidence: 99%

“…Progressive deformation of the capitate head is the result of insufficiency fractures in the repair zone. 45…”

Section: Osteonecrosis Of the Capitate Bonementioning

confidence: 99%

Osteonecrosis of the Upper Extremity: MRI-Based Zonal Patterns and Differential Diagnosis

Schmitt

Kalb

Christopoulos

et al. 2019

Semin Musculoskelet Radiol

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Regarding the upper extremity, osteonecrosis can relate to the humeral head and to any carpal bone, most commonly the lunate (Kienböck's disease), scaphoid (Preiser's disease and nonunion), and capitate bone (osteonecrosis of the capitate head). In children and adolescents, osteochondrosis is an important differential diagnosis at the epiphyses. Appropriate imaging of osteonecrosis depends on knowledge about blood supply, biomechanical load, and bone repair mechanisms. Contrast-enhanced MRI (ceMRI) enables the differentiation of up to three mostly band-shaped zones: necrotic tissue (proximal), hypervascular repair tissue (intermediate), and viable bone (distal). To distinguish between necrotic and repair zones, intravenous gadolinium is recommended in MRI. Osteosclerosis and insufficiency fractures in early and intermediate stages as well as osteoarthritis in advanced stages are best depicted using high-resolution CT (HRCT). The combination of HRCT and ceMRI allows for exact classification of osteonecrosis regarding morphology and viability.

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“…Pathoanatomie und Klinik Sie ist proximal am Kapitatumkopf lokalisiert und fast ausschließlich traumatischer Genese (25,49). nicht anheilen kann und letztlich immer eine Osteonekrose entsteht (50).…”

Section: Osteonekrose Des Kapitatumsunclassified

Karpale Osteonekrosen

Schmitt¹

2016

Osteologie

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ZusammenfassungIn den vergangenen Jahren haben die Kenntnisse zur Gefäßanatomie, zur Biomechanik und zu den Reparationsmechanismen maßgeblich die bildgebende Diagnostik von Osteonekrosen des Skaphoids (Skaphoidpseudarthrose, Morbus Preiser), des Lunatums (Morbus Kienböck) und des Kapitatums (Kapitatumkopfnekrose) beeinflusst. Die kontrastverstärkte MRT eignet sich zuverlässig zur Bestimmung der Vitalität des Knochenmarks. Bei den Osteonekrosen können mit der MRT drei Zonen abgegrenzt werden: Proximal die Nekrosezone, in der Mitte die Reparationszone und distal die Zone der verbliebenen Knochenmarksvitalität. Voraussetzung für die Abgrenzung der Osteonekroseund Reparationszonen ist die intravenöse Gabe von Gadolinium. Die hochaufgelöste CT dient in den Frühstadien der Darstellung von Osteosklerosen und Insuffizienzfrakturen sowie in den Spätstadien dem Nachweis von arthrotischen Umbauten. Mit den dedizierten Schnittbildverfahren können alle Stadien der karpalen Osteonekrosen zur Abbildung gebracht werden, nämlich von den Vorstufen und Reparationsmechanismen über die Zwischenstufen mit Osteosklerose und proximalen Frakturen bis zu den Endstadien der Arthrose und des karpalen Kollapses.

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Avascular necrosis of the capitate: report of six cases and review of the literature

Cited by 31 publications

References 41 publications

Mid-Carpal Joint Sparing Procedure for Idiopathic Avascular Necrosis of Capitate

Mid-Carpal Joint Sparing Procedure for Idiopathic Avascular Necrosis of Capitate

Osteonecrosis of the Upper Extremity: MRI-Based Zonal Patterns and Differential Diagnosis

Karpale Osteonekrosen

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