Simultaneous capitate and trapezoid fractures following a motor vehicle accident: A case report

Carpal fractures are relatively rare, and simultaneous fractures involving both the capitate and trapezoid bones are particularly uncommon, accounting for less than 2 % of all carpal injuries. These fractures usually result from high-energy trauma, such as motor vehicle accidents. Due to the deep anatomical position and strong ligamentous support of these bones, injuries may be subtle and easily missed on standard radiographs. Early diagnosis and appropriate management are essential to avoid long-term morbidity and ensure functional recovery.

We report the case of a 28-year-old previously healthy, non-smoking female with no known drug or food allergies, who presented with severe left wrist pain, swelling, and limited movement following a high-speed motor vehicle accident. Physical examination revealed tenderness on the dorsal aspect of the wrist with no neurovascular deficits. Radiographs raised suspicion for capitate and trapezoid fractures, which were confirmed by a CT scan showing comminuted coronal shear fractures with dorsal and radial displacement. Surgical fixation was performed and the fractures were reduced under fluoroscopic guidance and fixed with K-wires and Barouk screws. Postoperatively, a removable wrist brace was worn for six weeks, after which the patient achieved full wrist motion and pain resolution.

These fractures are challenging to diagnose and manage due to their rarity and subtle presentation. Advanced imaging, particularly CT scans, is critical for diagnosis. Early surgical intervention facilitates anatomic reduction and optimal outcomes.

This case underscores the importance of early recognition, advanced imaging, and individualized surgical care in managing rare, complex carpal fractures.