Capitate Fracture-Dislocation: An Unusual Pattern of Carpal Injury

Isolated dislocation of the capitate is an exceedingly rare carpal injury and is typically associated with high-energy trauma and complex ligamentous disruption. We present a case of a delayed-diagnosis isolated volar dislocation of the capitate with a small associated chip fracture, not conforming to classic perilunate instability patterns, and review relevant literature that describes similar case presentations and treatment modalities. A 29-year-old man presented with wrist pain and median nerve paresthesias 2 weeks after the injury. Imaging demonstrated volar migration of the proximal capitate relative to the lunate fossa. The patient underwent open reduction, carpal tunnel release, and temporary Kirschner wire fixation. At final follow-up, he demonstrated resolution of neuropathy and functional wrist motion. This case highlights an unusual injury pattern, emphasizes the importance of careful radiographic evaluation in patients with persistent symptoms, and suggests a potential mechanism of transient ligamentous failure rather than frank rupture.