Carpal Bone Fractures (Subscribe)  

The capitate is the largest carpal bone, though it is not the most frequently fractured, and is rarely fractured in isolation. Injuries to the capitate are often part of complex injuries. Capitate fractures are sometimes seen along with scaphoid waist fractures or distal radius fractures.

The carpus, or wrist, is a complex joint that provides abduction and adduction in the frontal plane of the upper extremity, extension and flexion for hand movements, and supination and pronation in the coronal plane.
Synonyms and related keywords: wrist bone injuries, wrist injuries, wrist sprain, broken wrist, sprained wrist, wrist...

It is important to suspect and recognise carpal injuries as they are difficult to diagnose and can cause permanent disability if untreated. The usual mechanism of injury causing a carpal fracture is either a fall onto the outstretched hand, or direct trauma to the wrist area. Higher impact injuries from...

This article addresses carpal fractures in the hand. Because treatment varies depending on the carpal element involved, fractures of the various bones are discussed individually.
Synonyms and related keywords: scaphoid fractures, triquetral fractures, lunate fractures, pisiform fractures, trapezial fractures, hamate fractures, capitate fractures, wrist fractures, broken wrist
Kouris & Schenck 2008

Case presentation An 11-year-old Caucasian boy presented with pain in the left wrist after a fall. Radiographs in the emergency department demonstrated a lunate that was divided into palmar and dorsal parts, causing a misdiagnosis of fractured lunate. Magnetic resonance imaging was then used to differentiate between the two diagnoses.
Conclusion Very few...

Carpal dislocation and fracture dislocation are uncommon and difficult to treat. Early diagnosis and treatment of such injuries are necessary to prevent progressive carpal instability and traumatic arthritis. Perilunate fracture dislocation is a combination of ligamentous and osseous injuries that involve the ‘greater arc’ of the perilunate. Despite being severe, these injuries often go unrecognised in the...

* a/w racquet-sport injury
* best evaluated by CT

Hamate fractures mainly occur in two locations - the hook of the hamate or the body. Hook of the hamate fractures are common in sports with hand held equipment where a direct blow occurs to the palm of the hand - for instance a baseball bat, golf club or tennis...

Hook of hamate fracture, plain films normal even in retrospect. Clearly seen only on the 3D CT.
Notes and illustrations

The lunate is the fourth most fractures carpal bone (following the scaphoid, triquetrum, and trapezium). They often are not diagnosed initially and present delayed as lunate osteonecrosis, which is also known as Kienbock disease. The mechanism of injury is typically a fall onto an outstretched hand with a hyperextended wrist...

Perilunate dislocations and perilunate fracture dislocations are the most devastating closed injuries of the wrist.1, 2, 3 They are often missed on initial evaluation, leading to devastating complications. These injuries occur as the final stage of a spectrum of injuries progressing around the wrist in a radial-to-ulnar direction. In the...

The pisiform is a sesamoid bone in the flexor carpi ulnaris tendon. Meaning "pea-shaped," this carpal bone is rare to fracture. Often pisiform fractures are with associated injuries - distal radius, hamate, or triquetrum. The mechanism of injury is usually by a direct blow to the palm when the wrist...

Hook of hamate fractures are prone to nonunion, and their diagnosis is frequently delayed or missed. Cronic nonunions may result in flexor tendon rupure and other complications. Treatment for most patients is excision of the small fracture fragment.

Full text of the 1972 paper J Bone Joint Surg Br Monahan and Galasko 54-B (1): 122.

Volar lunate fractures are rare injuries, usually seen as a result of high-energy trauma and often in association of other carpal injuries. We present 2 unusual cases of coronal volar lunate fractures. The first case involved a proximal pole scaphoid fracture in association with a volar lunate fracture. During surgical...