Assaf Kadar1, Mohamed Morsy2, Yoo-Joon Sur3, Osman Akdag4, Steven L Moran5. 1. Department of Plastic Surgery, Mayo Clinic, Rochester, MN; Orthopedic Division, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. Department of Plastic Surgery, Mayo Clinic, Rochester, MN; Department of Orthopedic Surgery, Assiut University Hospital, Assiut, Egypt. 3. Department of Plastic Surgery, Mayo Clinic, Rochester, MN; Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Republic of Korea. 4. Department of Plastic Surgery, Mayo Clinic, Rochester, MN; Department of Plastic Reconstructive and Aesthetic Surgery, Selcuk University, Konya, Turkey. 5. Department of Plastic Surgery, Mayo Clinic, Rochester, MN. Electronic address: moran.steven@mayo.edu.
Abstract
PURPOSE: To describe the demographics, diagnosis, management, and outcomes of capitate fractures in the adult and pediatric population treated in our institution. METHODS: We performed a retrospective chart and radiographic review of 53 patients with capitate fractures treated in our institution between 2002 and 2015. Patients' demographic characteristics, mechanism of injury, management including surgery-related data, and outcomes, including complications, were recorded. A radiographic evaluation of the location and pattern of the fracture was performed. RESULTS: Capitate fractures were prevalent in young males and older females. Fracture location was variable with 9 different locations; in addition 80% of patients had an associated fracture in the wrist or hand. The most common fracture pattern was the transscaphoid, transcapitate perilunate dislocation. Most diagnoses were made with the aid of advanced imaging. Within this series, there was only 1 case (4%) of fracture nonunion and there were no cases of avascular necrosis of the proximal pole in limited follow-up. Isolated capitate fractures were significantly more common in children. In addition, children had better functional outcomes than adults. CONCLUSIONS: This series provides updated information on this rare injury. Nonunion of the capitate, which was previously described as the most common complication, was rare in this cohort. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
PURPOSE: To describe the demographics, diagnosis, management, and outcomes of capitate fractures in the adult and pediatric population treated in our institution. METHODS: We performed a retrospective chart and radiographic review of 53 patients with capitate fractures treated in our institution between 2002 and 2015. Patients' demographic characteristics, mechanism of injury, management including surgery-related data, and outcomes, including complications, were recorded. A radiographic evaluation of the location and pattern of the fracture was performed. RESULTS: Capitate fractures were prevalent in young males and older females. Fracture location was variable with 9 different locations; in addition 80% of patients had an associated fracture in the wrist or hand. The most common fracture pattern was the transscaphoid, transcapitate perilunate dislocation. Most diagnoses were made with the aid of advanced imaging. Within this series, there was only 1 case (4%) of fracture nonunion and there were no cases of avascular necrosis of the proximal pole in limited follow-up. Isolated capitate fractures were significantly more common in children. In addition, children had better functional outcomes than adults. CONCLUSIONS: This series provides updated information on this rare injury. Nonunion of the capitate, which was previously described as the most common complication, was rare in this cohort. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.