Most capitate fractures occur in association with additional carpal injuries, particularly scaphoid fractures. Isolated fractures of the capitate account for only 0.3% of carpal injuries, and stress fractures are one form of this fracture. We report the case of a 20-year-old male who had a stress fracture of the capitate after serving as an honor guard in the military. Conventional radiographs and computed tomography of the right wrist revealed a minimally displaced fracture line located at the midcarpal aspect of the right capitate. A magnetic resonance imaging scan demonstrates a subarticular capitate fracture with diffuse bone marrow edema, small osteophytes, and irregularity of the midcarpal articular cartilage. We also review the carpal kinematics which possibly caused the stress fracture. Although stress fractures of the capitate are rare, they should also be accounted for with patients who perform repetitive motions of the wrist to a considerable extent.
Biomechanical Phenomena ; Bone Marrow ; Capitate Bone ; Carpal Bones ; Cartilage, Articular ; Edema ; Fractures, Stress ; Humans ; Magnetic Resonance Imaging ; Male ; Military Personnel ; Multidetector Computed Tomography ; Osteophyte ; Wrist ; Young Adult

A carpal coalition that indicates the fusion of two carpal bones resulting from the failure of differentiation is a rare condition compared to the tarsal coalition. The most common carpal coalition is the luno-triquetral coalition, followed by the capitate-hamate coalition. Most of these coalitions are usually asymptomatic. Thus far, only a few cases of a coalition between the scaphoid and lunate with accompanied anomalies in the ipsilateral hand, such as accessory carpal bone or ray deficiency, have been reported. We present, for the first time, a case of a symptomatic isolated scapho-lunate coalition without any accompanying anomalies.
Carpal Bones ; Hand

The wrist joint is a complicated structure composed of many bones and ligaments. Therefore, understanding the anatomy and the biomechanics of the wrist is important in order to administer proper treatment for patients. To easily understand the complicated structure, there were many trials to unite the complicated structure with a simple group such as the carpal row concept and the carpal column concept. Movement and load transfer along the wrist joint occurs with balanced action between carpal bones. To evaluate this static equilibrium, measuring tools such as carpal height ratio are used. When wrist flexion/extension occurs, each carpal row moves synchronously with action of the scaphoid. In contrast with flexion/extension, when wrist radial deviation/ulnar deviation occurs, the proximal carpal row moves in the sagittal plane, instead of the coronal plane. Recently, the dart throwing motion which occurred from the position of dorsiflexion with radial deviation to volar flexion with ulnar deviation is considered the main movement of the wrist joint.
Carpal Bones ; Humans ; Ligaments ; Range of Motion, Articular ; Wrist Joint ; Wrist*

The wrist joint is formed by the distal end of the radius and ulna proximally, and eight carpal bones distally. It has many ligaments to maintain stability of the complex bony structures. The incidence of ligament injuries of the wrist has increased due to sports activities. However, diagnosis and management of these injuries are sometimes difficult because of the anatomic complexity and variable injury patterns. Among them, scapholunate ligament injury and triangular fibrocartilage tears are the two most common injuries resulting in chronic disabling wrist pain. Thorough understanding of the wrist anatomy and physical and radiologic examination is mandatory for proper diagnosis and management of these conditions. This article will briefly discuss the wrist joint anatomy and biomechanics, and review the diagnosis and management of the scapholunate ligament injury and triangular fibrocartilage injury.
Carpal Bones ; Diagnosis* ; Incidence ; Ligaments* ; Radius ; Sports ; Tears ; Triangular Fibrocartilage ; Ulna ; Wrist Joint ; Wrist*

PURPOSE: The purpose of this study is to evaluate the incidence and characteristics of concomitant carpal bone fractures and ligament injuries and to analyze risk factors for carpal injuries in patients with distal radius fractures. MATERIALS AND METHODS: A total of 362 patients with 379 distal radius fractures were reviewed retrospectively. Associated carpal bone fractures and ligament injuries were evaluated by plain radiographs and computed tomography at the time of initial trauma. Correlation between associated carpal injuries and various parameters was also analyzed. RESULTS: Of 379 distal radius fractures, 39 cases (10.3%) had one or more carpal bone fracture and 40 cases (10.6%) had carpal ligament injuries. Overall, carpal injuries occurred in 59 cases (15.6%) distal radius fractures. Associated carpal ligament injuries showed correlation with young age and associated carpal bone fractures showed correlation with AO type B distal radius fractures. Carpal injuries including fracture and ligament injury showed correlation with male, high energy trauma, or associated injuries beyond wrist. CONCLUSION: The incidence of concomitant carpal injuries in patients with distal radius fractures is relatively high. Concomitant carpal injuries were more common in young age, male, high energy trauma, AO type B distal radius fractures, or associated injuries beyond wrist.
Carpal Bones ; Humans ; Incidence ; Ligaments ; Male ; Radius Fractures* ; Retrospective Studies* ; Risk Factors ; Wrist

Trapezoid fracture is a rare condition and especially, isolated trapezoid fracture is most rare condition of carpal bone fracture. And principle of treatment has not yet been established. Most of trapezoid fractures can be treated using cast but displaced fracture or fracture combined with other carpal bone fractures may require operative treatment. There have been reports about case of conservative treatment in trapezoid stress fracture but no report about case of operative management. We treated a trapezoid stress fracture in a weight lifting athlete by operative treatment and report the results with literature review.
Athletes ; Carpal Bones ; Fractures, Stress* ; Humans ; Trapezoid Bone ; Weight Lifting

No abstract available.
Carpal Bones/*injuries ; Female ; Fractures, Bone/*complications ; Hand Injuries/*complications ; Humans ; Male ; Radius Fractures/*complications

OBJECTIVETo investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury.

METHODSFrom May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method.

RESULTSAll incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case.

CONCLUSIONThe application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.

Adolescent ; Adult ; Carpal Joints ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Hamate Bone ; injuries ; surgery ; Humans ; Male ; Metacarpal Bones ; injuries ; surgery ; Metacarpophalangeal Joint ; injuries ; surgery ; Middle Aged ; Sutures ; utilization ; Young Adult

Although intraosseous ganglion of the carpal bones is an uncommon lesion, it can be a cause of chronic wrist pain. Especially, pathologic fracture as complication of idiopathic intraosseous ganglion of the lunate is extremely rare. We report a rare case of idiopathic intraosseous ganglion with pathologic fracture of the lunate that was successfully treated by curettage and autogenous cancellous bone graft.
Bone Cysts* ; Carpal Bones ; Curettage ; Fractures, Spontaneous* ; Transplants ; Wrist

PURPOSE: The purpose of this study is to determine the frequency of missed fractures in severe multiple trauma patients and to analyze any differences in treatment plan, after whole body bone scan. MATERIALS AND METHODS: From September 2012 to December 2013, 49 patients were confirmed to have multiple trauma with an injury severity score (ISS) of 16 or higher. Whole body bone scan was performed at an average of 15.7 days (7-25) after injury. Missed fractures were diagnosed according to physical examination and additional radiologic reports. Locations and patterns of missed fractures were analyzed. We evaluated any differences in treatment plan after the diagnosis of missed fractures. RESULTS: Missed fractures were diagnosed in 14 patients (16 cases) on the whole body bone scan. The most frequent location was the knee (three cases), followed by rib, clavicle, carpal bone, and foot. Seven cases were occult fractures, five cases were undisplaced fractures and four cases were displaced fractures. Conservative treatment was administered in 15 patients and surgery was necessary in one patient. CONCLUSION: Delayed or missed diagnosis of fractures occurred frequently in patients of multiple trauma with a high ISS. Whole body bone scan appears to be effective in finding missed fractures in the whole body. Definitive assessment should be supplemented after initial trauma care in order to reduce the rate of missed fractures.
Carpal Bones ; Clavicle ; Diagnosis ; Foot ; Fractures, Closed ; Humans ; Injury Severity Score ; Knee ; Multiple Trauma* ; Physical Examination ; Ribs