The scaphocapitate fracture syndrome: report of a case and a review of the literature

Abstract

The Fenton's syndrome or scaphocapitate fracture syndrome has been described since 1950. This severe and uncommon injury occurs after a high-energy trauma of the wrist. This syndrome associated the fractures of the scaphoid and capitate, with a rotation of 90° or 180° of the proximal fragment of the capitate. The diagnosis is determined by careful physical and radiological examinations, including conventional radiographs. Computed tomography can be helpful in detecting such lesions. We report one case of Fenton's syndrome that occurred after a high-energy trauma in a 22-year-old male. We discuss the mechanisms of the injury and the results of treatment.

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

“…2,12 There is a general consensus among authors that injuries of this variety require open anatomic reduction of both the capitate and scaphoid, followed by internal fixation. 2,5,7,[11][12][13] Although the proximal portions of both the capitate and scaphoid are vulnerable to posttraumatic avascular necrosis due to the retrograde blood supply of these fragments, the capitate head is nourished by synovial fluid and has demonstrated the ability to revascularize when anatomically reduced. 14 Excision of the proximal capitate fragment will lead to a predictable progression of degenerative arthritis 6 ; thus, regardless of the injury pattern, salvage of this fragment should always be attempted.…”

“…1,2 This carpal injury is characterized by transverse fractures of both the scaphoid and capitate with subsequent rotation of the proximal capitate to either 90° or 180°. 3,4 Few cases of this unusual fracture pattern have been reported since 1956, 2,3,[5][6][7] when Fenton first defined this phenomenon. 8 Scaphocapitate syndrome is considered a unique subset of perilunate instability.…”

Scaphocapitate Syndrome With Associated Trans-Scaphoid, Trans-Hamate Perilunate Dislocation

“…Today, open anatomic reduction and internal fixation is the treatment of choice for displaced carpal fractures. 3,6 The head of the capitate is nourished by synovial fluid and has the ability to revascularize if it is reduced anatomically and stabilized. 8 As with isolated scaphoid fractures, prompt stabilization with compression screw reduces the risk of avascular necrosis, and bone grafting may be indicated in cases with severe comminution.…”

“…Scaphocapitate syndrome was initially described by Fenton, 2 and very few cases have been reported in the literature. 1,3,6,7,10 It is characterized by fracture of the scaphoid and the capitate with 90° to 180° reversal of the head of the capitate. We report a unique case of scaphocapitate fracture syndrome with associated perilunate dislocation and describe the surgical fixation.…”

About a painful wrist after a forced dorsiflexion trauma

“…Capitate fracture is very rare, and in most of the cases, it is associated with scaphoid fracture, 180° rotation of the capitate and periulnate dislocation (Fenton’s syndrome1). Isolated capitate fractures constitute only 0.3% of wrist fractures 2…”