Capitate Fractures: A Review of 53 Patients.

PURPOSE: To describe the demographics, diagnosis, management, and outcomes of capitate fractures in the adult and pediatric population treated in our institution.

METHODS: We performed a retrospective chart and radiographic review of 53 patients with capitate fractures treated in our institution between 2002 and 2015. Patients' demographic characteristics, mechanism of injury, management including surgery-related data, and outcomes, including complications, were recorded. A radiographic evaluation of the location and pattern of the fracture was performed.

RESULTS: Capitate fractures were prevalent in young males and older females. Fracture location was variable with 9 different locations; in addition 80% of patients had an associated fracture in the wrist or hand. The most common fracture pattern was the transscaphoid, transcapitate perilunate dislocation. Most diagnoses were made with the aid of advanced imaging. Within this series, there was only 1 case (4%) of fracture nonunion and there were no cases of avascular necrosis of the proximal pole in limited follow-up. Isolated capitate fractures were significantly more common in children. In addition, children had better functional outcomes than adults.

CONCLUSIONS: This series provides updated information on this rare injury. Nonunion of the capitate, which was previously described as the most common complication, was rare in this cohort.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.