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Carpal fractures excluding the scaphoid.

Mordechai Vigler1, Alberto Aviles, Steve K Lee

  • 1Hand Surgery Service, New York University Hospital for Joint Diseases Orthopaedic Institute, Department of Orthopaedic Surgery, The New York University School of Medicine, New York, NY 10003, USA.

Hand Clinics
|November 14, 2006
PubMed
Summary

Diagnosing uncommon carpal fractures requires vigilance, as subtle findings on physical exams and X-rays necessitate advanced imaging. Treatment varies, with nonoperative care for non-displaced fractures and surgical fixation for intra-articular injuries.

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Musculoskeletal System

Background:

  • Carpal fractures, excluding the scaphoid, are infrequent but can be serious.
  • Subtle physical examination findings and standard radiographs may complicate diagnosis.
  • Early and effective treatment is crucial for optimal outcomes.

Purpose of the Study:

  • To review and organize current knowledge on diagnosing and treating non-scaphoid carpal fractures.
  • To provide guidelines for managing these potentially challenging injuries.
  • To emphasize the importance of accurate diagnosis for appropriate treatment.

Main Methods:

  • Review of current literature on carpal bone fractures.
  • Discussion of diagnostic modalities including physical examination, standard radiography, special radiographic views, and computed tomography (CT).

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  • Organization of diagnostic and treatment strategies based on fracture characteristics.

    • Main Results:

    • Non-displaced carpal fractures can often be managed nonoperatively.
    • Intra-articular carpal bone fractures with any displacement are generally unacceptable and require surgical reduction and fixation.
    • Advanced imaging like CT is valuable for elucidating complex fractures.

    Conclusions:

    • Vigilance in diagnosing non-scaphoid carpal fractures is essential.
    • Treatment must be tailored to the specific fracture type and displacement.
    • A structured approach to diagnosis and treatment improves patient care for these uncommon injuries.