Lai CC, Fang HW, Chang CH, Pao JL, Chang CC, Chen YJ. Unusual capitate fracture with dorsal shearing pattern and concomitant carpometacarpal dislocation with a 6-year follow-up: A case report. World J Clin Cases 2023; 11(9): 2060-2066 [PMID: 36998955 DOI: 10.12998/wjcc.v11.i9.2060]
Corresponding Author of This Article
Yeong-Jang Chen, MD, Surgeon, Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, No. 69 Guizi Road, Taishan District, New Taipei City 243, Taiwan. yjchen71@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Chien-Cheng Lai, Chih-Hung Chang, Jwo-Luen Pao, Chun-Chien Chang, Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
Chien-Cheng Lai, Hsu-Wei Fang, Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei 106, Taiwan
Chih-Hung Chang, Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan 320, Taiwan
Yeong-Jang Chen, Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, Taiwan
Author contributions: Lai CC contributed to data acquisition, measurements, and analysis and was involved in the conception and design of the study; Fang HW, Chang CH, Pao JL, Chang CC, and Chen YJ performed data acquisition, measurements, and analysis and were involved in the conception and design of the study; Chen YJ performed the surgery; all authors reviewed the draft manuscript and approved the final version.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yeong-Jang Chen, MD, Surgeon, Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, No. 69 Guizi Road, Taishan District, New Taipei City 243, Taiwan. yjchen71@gmail.com
Received: December 2, 2022 Peer-review started: December 2, 2022 First decision: February 2, 2023 Revised: February 10, 2023 Accepted: February 27, 2023 Article in press: February 27, 2023 Published online: March 26, 2023 Processing time: 105 Days and 7.1 Hours
Abstract
BACKGROUND
Isolated capitate fractures are rare carpal fractures. Following high-energy injuries, capitate fractures are usually associated with other carpal fractures or ligament injuries. The management of capitate fractures depends on the fracture pattern. Here, we report an unusual capitate fracture with a dorsal shearing pattern and concomitant carpometacarpal dislocation, with a 6-year follow-up. To the best of our knowledge, this fracture pattern and surgical management have not been previously reported.
CASE SUMMARY
A 28-year-old man presented with left-hand volar tenderness and decreased grip strength that persisted for one month after a traffic accident. Radiography showed a distal capitate fracture with carpometacarpal joint incongruence. Computed tomography (CT) revealed a distal capitate fracture with carpometacarpal joint dislocation. The distal fragment was rotated by 90° in the sagittal plane, and an oblique shearing fracture pattern was noted. Open reduction and internal fixation (ORIF) with a locking plate were performed using the dorsal approach. The imaging studies performed 3 mo and 6 years following surgery revealed a healed fracture, and the Disabilities of the Arm, Shoulder, and Hand and visual analog scale scores were significantly improved.
CONCLUSION
CT can detect capitate fractures with dorsal shearing pattern and concomitant carpometacarpal dislocation. ORIF using a locking plate are possible.
Core Tip: Isolated capitate fractures with distal fragment rotated by 90° in the sagittal plane, dorsal shearing pattern and concomitant carpometacarpal dislocation have not been previously reported. Open reduction and internal fixation with a locking plate using the dorsal approach are possible. Long term radiological and clinical outcomes, including the Disabilities of the Arm, Shoulder, and Hand and visual analog scale scores were improved significantly.
