• Daniel Ossowski, ThomsenNiels O BNOBDepartment of Hand Surgery, Institute of Translational Medicine, Skåne University Hospital Malmö and Lund University, Jan Waldenströms gata 5, Malmö, 205 02, Sweden., Martin Clementson, Jack Besjakov, Peter Jörgsholm, and Anders Björkman.
• Department of Hand Surgery, Institute of Translational Medicine, Skåne University Hospital Malmö and Lund University, Jan Waldenströms gata 5, Malmö, 205 02, Sweden. Daniel.ossowski@med.lu.se.
• Arch Orthop Trauma Surg. 2024 Aug 1; 144 (8): 388538933885-3893.

IntroductionThe long-term effects of a capitate fracture are unknown. The aim of this study was to assess both clinical and radiological long-term outcomes after a capitate fracture.Materials And MethodsFrom a cohort of 526 consecutive patients with post traumatic radial sided wrist pain, 23 were identified diagnosed with a capitate fracture. 16 of these (11 males and 5 females) with a median age at injury of 17.5 years (range 11-27 years) were eligible for a follow-up after a median of 16 years (range 8 to 17 years). In this study patients were examined using conventional radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) at the time of injury and with CT at the follow-up. At follow-up radiological signs of osteoarthritis were graded in four stages and clinical outcome was evaluated by measuring range of wrist motion and grip and pinch strength. The subjective outcome was assessed using DASH and PRWE questionnaires.ResultsFive patients had isolated capitate fractures and 11 had concomitant fractures, 10 of which had a simultaneous scaphoid fracture. 14 patients had been treated non-surgically in a cast and two patients were treated surgically. None of the fractures were visible on conventional radiographs at the time of injury. At follow-up all fractures had healed without signs of avascular necrosis. In one patient, CT examination revealed osteoarthritis between the capitate and lunate. This did not cause clinical symptoms. Functional impairments and pain scores were low: median DASH score 0, median PRWE 3 and median VAS pain score 0. We found no impairment in range of motion or grip and pinch strength.ConclusionsAt a median of 16-year follow-up, patients with a capitate fracture report normal self-assessed hand function as well as good wrist motion and strength. The risk of development of posttraumatic arthritis in the joints around the capitate is low.© 2024. The Author(s).

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