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[Pseudarthrosis of the capitate]
Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|May 1, 1986
Summary
Isolated non-unions of the capitate bone can remain asymptomatic for extended periods. Surgical intervention using only a cancellous graft may lead to wrist dysfunction, necessitating restoration of bone length and a cortico-spongious graft for optimal outcomes.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Traumatology
Background:
- A 54-year-old male railway engine-driver sustained a right hand injury in November 1978.
- A previous similar, but painless, trauma occurred 14 months prior to the second incident.
Observation:
- Tomographic X-ray revealed an isolated non-union of the capitate bone with shortening.
- The patient underwent autologous grafting using the Matti technique four days post-injury.
Findings:
- The non-union healed within three months, with the patient returning to work in four months.
- Four years and nine months later, the patient reported persistent pain on exertion, moderate wrist mobility reduction, and unchanged capitate shortening.
Implications:
- Isolated capitate non-unions can be asymptomatic for prolonged durations, similar to scaphoid non-unions.
- Cancellous grafts alone may not restore full wrist function due to carpal collapse.
- Restoring capitate length with a cortico-spongious graft is recommended for improved long-term results.