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Long-term outcomes after capitate fractures : a median 16-year follow-up

Ossowski, Daniel LU ; Thomsen, Niels O.B. LU ; Clementson, Martin LU ; Besjakov, Jack LU ; Jörgsholm, Peter LU and Björkman, Anders LU (2024) In Archives of Orthopaedic and Trauma Surgery 144(8). p.3885-3893
Abstract

Introduction: The long-term effects of a capitate fracture are unknown. The aim of this study was to assess both clinical and radiological long-term outcomes after a capitate fracture. Materials and methods: From a cohort of 526 consecutive patients with post traumatic radial sided wrist pain, 23 were identified diagnosed with a capitate fracture. 16 of these (11 males and 5 females) with a median age at injury of 17.5 years (range 11–27 years) were eligible for a follow-up after a median of 16 years (range 8 to 17 years). In this study patients were examined using conventional radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) at the time of injury and with CT at the follow-up. At follow-up radiological signs of... (More)

Introduction: The long-term effects of a capitate fracture are unknown. The aim of this study was to assess both clinical and radiological long-term outcomes after a capitate fracture. Materials and methods: From a cohort of 526 consecutive patients with post traumatic radial sided wrist pain, 23 were identified diagnosed with a capitate fracture. 16 of these (11 males and 5 females) with a median age at injury of 17.5 years (range 11–27 years) were eligible for a follow-up after a median of 16 years (range 8 to 17 years). In this study patients were examined using conventional radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) at the time of injury and with CT at the follow-up. At follow-up radiological signs of osteoarthritis were graded in four stages and clinical outcome was evaluated by measuring range of wrist motion and grip and pinch strength. The subjective outcome was assessed using DASH and PRWE questionnaires. Results: Five patients had isolated capitate fractures and 11 had concomitant fractures, 10 of which had a simultaneous scaphoid fracture. 14 patients had been treated non-surgically in a cast and two patients were treated surgically. None of the fractures were visible on conventional radiographs at the time of injury. At follow-up all fractures had healed without signs of avascular necrosis. In one patient, CT examination revealed osteoarthritis between the capitate and lunate. This did not cause clinical symptoms. Functional impairments and pain scores were low: median DASH score 0, median PRWE 3 and median VAS pain score 0. We found no impairment in range of motion or grip and pinch strength. Conclusions: At a median of 16-year follow-up, patients with a capitate fracture report normal self-assessed hand function as well as good wrist motion and strength. The risk of development of posttraumatic arthritis in the joints around the capitate is low.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Avascular necrosis, Capitate, Carpal bone fracture, Carpal bones, Scaphocapitate syndrome, Wrist
in
Archives of Orthopaedic and Trauma Surgery
volume
144
issue
8
pages
9 pages
publisher
Springer
external identifiers
  • pmid:39174766
  • scopus:85201962887
ISSN
0936-8051
DOI
10.1007/s00402-024-05495-z
language
English
LU publication?
yes
id
9f75f0fa-7272-4615-bcae-a07dd53c1fea
date added to LUP
2024-10-31 15:06:39
date last changed
2025-06-13 10:56:36
@article{9f75f0fa-7272-4615-bcae-a07dd53c1fea,
  abstract     = {{<p>Introduction: The long-term effects of a capitate fracture are unknown. The aim of this study was to assess both clinical and radiological long-term outcomes after a capitate fracture. Materials and methods: From a cohort of 526 consecutive patients with post traumatic radial sided wrist pain, 23 were identified diagnosed with a capitate fracture. 16 of these (11 males and 5 females) with a median age at injury of 17.5 years (range 11–27 years) were eligible for a follow-up after a median of 16 years (range 8 to 17 years). In this study patients were examined using conventional radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) at the time of injury and with CT at the follow-up. At follow-up radiological signs of osteoarthritis were graded in four stages and clinical outcome was evaluated by measuring range of wrist motion and grip and pinch strength. The subjective outcome was assessed using DASH and PRWE questionnaires. Results: Five patients had isolated capitate fractures and 11 had concomitant fractures, 10 of which had a simultaneous scaphoid fracture. 14 patients had been treated non-surgically in a cast and two patients were treated surgically. None of the fractures were visible on conventional radiographs at the time of injury. At follow-up all fractures had healed without signs of avascular necrosis. In one patient, CT examination revealed osteoarthritis between the capitate and lunate. This did not cause clinical symptoms. Functional impairments and pain scores were low: median DASH score 0, median PRWE 3 and median VAS pain score 0. We found no impairment in range of motion or grip and pinch strength. Conclusions: At a median of 16-year follow-up, patients with a capitate fracture report normal self-assessed hand function as well as good wrist motion and strength. The risk of development of posttraumatic arthritis in the joints around the capitate is low.</p>}},
  author       = {{Ossowski, Daniel and Thomsen, Niels O.B. and Clementson, Martin and Besjakov, Jack and Jörgsholm, Peter and Björkman, Anders}},
  issn         = {{0936-8051}},
  keywords     = {{Avascular necrosis; Capitate; Carpal bone fracture; Carpal bones; Scaphocapitate syndrome; Wrist}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{3885--3893}},
  publisher    = {{Springer}},
  series       = {{Archives of Orthopaedic and Trauma Surgery}},
  title        = {{Long-term outcomes after capitate fractures : a median 16-year follow-up}},
  url          = {{http://dx.doi.org/10.1007/s00402-024-05495-z}},
  doi          = {{10.1007/s00402-024-05495-z}},
  volume       = {{144}},
  year         = {{2024}},
}