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Neglected Scaphocapitate Syndrome.

Assaf Kadar1, Sorin D Iordache1

  • 1Department of Orthopedic Surgery, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Journal of Wrist Surgery
|March 16, 2023
PubMed
Summary
This summary is machine-generated.

Scaphocapitate syndrome, a rare wrist injury, involves capitate rotation. This case shows preserved capitate vascularity even in neglected injuries over 30 years, challenging previous assumptions.

Keywords:
avascular necrosiscapitatecarpal bonesscaphocapitate syndromewrist

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Radiology

Background:

  • Scaphocapitate syndrome involves 90-180 degree rotation of the capitate's proximal pole.
  • Traditionally, this injury was thought to cause avascularity of the capitate's proximal pole due to retrograde vascular supply.
  • Recent studies and this case challenge the paradigm of inevitable avascular necrosis.

Observation:

  • A unique case of a neglected scaphocapitate syndrome with over 30 years of follow-up is presented.
  • Despite significant displacement and neglect, T1 MRI demonstrated preserved vascularity of the capitate's proximal pole.
  • The patient did develop midcarpal arthritis, a known complication.

Findings:

  • The neglected scaphocapitate syndrome did not result in avascular necrosis of the capitate proximal pole.
  • This finding contrasts with the traditional understanding of the injury's vascular implications.
  • Long-term follow-up revealed preserved capitate bone viability.

Implications:

  • This case suggests that the proximal pole of the capitate may retain vascularity even in chronic, displaced scaphocapitate injuries.
  • It highlights the potential for non-operative management or delayed intervention in specific long-standing cases.
  • Further research into the capitate's vascularity in chronic fractures is warranted.