Capitate fracture: Difference between revisions
(Created page with "==Background== *Isolated capitate fractures are rare; most often occur along w/ scaphoid fx *Occurs via forceful dorsiflexion of hand w/ impact on radial side *Proximal fracture ...") |
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==Background== | ==Background== | ||
*Isolated capitate fractures are rare | *Isolated capitate fractures are rare ([[Scaphoid fracture|scaphoid]] is most common associated fracture) | ||
*Occurs via forceful dorsiflexion of hand | *Occurs via forceful dorsiflexion of hand (FOOSH injury) with impact on radial side | ||
*Proximal fracture fragment at risk for avascular necrosis | *Proximal fracture fragment at risk for [[avascular necrosis]] | ||
==Clinical Features== | ==Clinical Features== | ||
*Diffuse swelling and tenderness over capitate (just proximal to 3rd metacarpal) | *Diffuse swelling and tenderness over capitate (just proximal to 3rd metacarpal) | ||
== | ==Differential Diagnosis== | ||
* | {{Carpal fractures}} | ||
*Often overlooked | |||
==Evaluation== | |||
*Hand x-ray | |||
*Often overlooked due to accompanying [[scaphoid fracture]] or [[Perilunate and lunate dislocations|lunate/perilunate dislocation]] | |||
[[File:Capitate_Fracture.jpg|thumb|Capitate fracture]] | |||
==Management== | ==Management== | ||
*Isolated capitate | {{General Fracture Management}} | ||
*Capitate | |||
===Specific Management=== | |||
*Isolated capitate fracture requires [[forearm volar splint]] immobilization and early ortho referral | |||
*Capitate fracture associated with [[scaphoid fracture]] or dislocations requires surgical treatment | |||
==Disposition== | |||
*Generally may be dishcarged | |||
== | ==See Also== | ||
[[ | *[[Carpal fractures]] | ||
== | ==References== | ||
<references/> | |||
[[Category: | [[Category:Orthopedics]] | ||
Latest revision as of 04:49, 18 September 2019
Background
- Isolated capitate fractures are rare (scaphoid is most common associated fracture)
- Occurs via forceful dorsiflexion of hand (FOOSH injury) with impact on radial side
- Proximal fracture fragment at risk for avascular necrosis
Clinical Features
- Diffuse swelling and tenderness over capitate (just proximal to 3rd metacarpal)
Differential Diagnosis
Carpal fractures
- Scaphoid fracture
- Lunate fracture
- Triquetrum fracture
- Pisiform fracture
- Trapezium fracture
- Trapezoid fracture
- Capitate fracture
- Hamate fracture
Evaluation
- Hand x-ray
- Often overlooked due to accompanying scaphoid fracture or lunate/perilunate dislocation
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Specific Management
- Isolated capitate fracture requires forearm volar splint immobilization and early ortho referral
- Capitate fracture associated with scaphoid fracture or dislocations requires surgical treatment
Disposition
- Generally may be dishcarged