Scaphocapitate fracture syndrome in a child
- Authors: Wircker P.1, Alves da Silva T.1, Dias R.1
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Affiliations:
- Hospital de Cascais
- Issue: Vol 9, No 4 (2021)
- Pages: 471-476
- Section: Clinical cases
- URL: https://journals.eco-vector.com/turner/article/view/79275
- DOI: https://doi.org/10.17816/PTORS79275
- ID: 79275
Cite item
Abstract
BACKGROUND: Scaphocapitate fracture syndrome involves transverse fracture of the scaphoid and capitate, with rotation of 90° or 180° of the proximal fragment of the capitate, commonly associated with other carpal lesions. It is a rare wrist injury, usually occurs in young men and is exceptional in children. The exact mechanism remains controversial. The injury is often misdiagnosed as a simple scaphoid fracture and there has been a controversy about the treatment of the capitate fracture in this syndrome.
CLINICAL CASE: The authors report a rare case of a scaphocapitate syndrome in a 15-year-old boy. Early open reduction of both fractures was performed. It was obtained a good mobility, with a normal grip strength and the radiographs showed union of both bones without avascular necrosis.
DISCUSSION: Most authors agree that regardless of the radiographic appearance of the injury, open reduction and internal fixation is the treatment of choice. The dorsal approach is the most used. The capitate fragment is usually devoid of any soft tissues and is reduced relatively easy with manual pressure, by applying traction to the hand. Reduction and fixation of the capitate must precede that of the scaphoid. K-wires or headless screws may be placed from the proximal to the distal side for the fixation of the scaphoid and capitate. The evolution is marked by the risk of occurrence of head capitate avascular necrosis
CONCLUSIONS: This case report illustrates that the scaphocapitate syndrome can occur in children and is important an early diagnosis to initiate timely treatment. Our patient was successfully treated with open reduction and fixation using K-wires.
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About the authors
Patrícia Wircker
Hospital de Cascais
Email: patriciawircker@gmail.com
ORCID iD: 0000-0002-2731-5868
Trauma and Orthopedic Surgery Resident
Portugal, Av. Brigadeiro Victor Novais Gonçalves, 2755-009 Alcabideche, LisbonTeresa Alves da Silva
Hospital de Cascais
Email: alvesdasilva.t@gmail.com
Trauma and Orthopedic Surgeon
Portugal, Av. Brigadeiro Victor Novais Gonçalves, 2755-009 Alcabideche, LisbonRafael Dias
Hospital de Cascais
Author for correspondence.
Email: rafaelrmdias@gmail.com
Trauma and Orthopedic Surgery Resident
Portugal, Av. Brigadeiro Victor Novais Gonçalves, 2755-009 Alcabideche, LisbonReferences
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