J Wrist Surg 2023; 12(02): 143-146
DOI: 10.1055/s-0041-1740402
Case Report

Neglected Scaphocapitate Syndrome

1   Department of Orthopedic Surgery, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Sorin D. Iordache
1   Department of Orthopedic Surgery, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
› Author Affiliations
Funding None.

Abstract

Background Scaphocapitate syndrome is a rare injury where the proximal pole of the capitate rotates 90 to 180 degrees. The proximal pole of the capitate, thought to receive its vascular supply retrograde, is rendered avascular in such cases. However, recent evidence of low rates of avascular necrosis in displaced capitate fractures, and new vascular studies of the capitate, challenge this paradigm.

Case Description We report a case of a missed and neglected scaphocapitate syndrome with more than 30 years follow-up. While the patient experienced midcarpal arthritis, the injury had not resulted in capitate proximal pole avascular necrosis as per T1 magnetic resonance imaging studies.

Literature Review Missed and chronic cases of scaphocapitate syndrome were reported previously. Successful outcomes were achieved with anatomical reduction in cases without midcarpal arthritis. Salvage procedures or arthroplasty procedures are recommended with the presence of midcarpal arthritis. However, there are no reports of a neglected case with more than 30 years follow-up with preserved vascularity of the proximal pole of the capitate.

Clinical Relevance This case illustrates that vascularity of the proximal pole of the capitate can be preserved even in longstanding displaced fractures.

Authors' Contributions

A.K. wrote the first draft of the manuscript. S.D.I. edited and revised the final version. All authors reviewed and edited the manuscript and approved the final version of the manuscript.




Publication History

Received: 14 March 2021

Accepted: 22 October 2021

Article published online:
23 December 2021

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