The scapho-capitate fracture syndrome is a rare but severe injury of the carpus. It is characterized by a rotation of the proximal fragment of the capitate bone of 90 or 180 degrees and a fracture of the navicular bone in the intermediate third. This injury is caused by a fall on the outstretched and dorsiflected hand. The scapho-capitate fracture syndrome was firstly described in 1956 by Fenton. There are 31 cases described in literature but none of these involves both hands. Here we describe the first case of scapho-capitate fracture syndrome in both hands, in a 21 year old woman who jumped out of a window with suicidal intentions. She was treated operatively by Herbert-screws and K-wires.
With the case of a 25 year old patient we will report of a rare injury, the isolated body fracture of a triquetrum bone. This kind of injury often happens in dorsalflected and ulnarducted hand position because of the anatomical position of the triquetral bone. The therapy of choice is conservative treatment with a volar splint for three to six weeks. Operation is only necessary in case of dislocation of a fragment [4]. Complications as an aseptic necrosis of a fragment is not reported. We found only one case of a pseudarthrosis [5]. Even in our case occurred a complete healing of the bone and a complete functional remission.
Conclusive comparative studies on the incidence and severity of hand injuries directly related to combat sports action could not be found in the currently available literature. The overall risk of suffering from a sports injury seems to be relatively low in combat sports compared to other sports. Boxing, however, seems to be the most dangerous sport for injuries to the upper extremities and especially the hand. The injury pattern after punching (emergency patients and professional boxers) shows that more than half of these fractures affect the 5th metacarpal and 25% of these are the classical boxer's fracture. This differs significantly from the fracture distribution generally associated with sports, where fractures of the phalanges are the most common. Two rare conditions that may occur as a result of repeated punching are referred to as carpal bossing and boxer's knuckle and excellent results are described for both injury forms after surgical therapy.
Perilunate injuries are one of the most severe injuries of the hand. They occur relatively rarely but necessitate that diagnostic procedures should be carried out thoroughly and as soon as possible. The therapeutic strategy must consider the age, exact type and full extent of the injury. The key for successful treatment is exact anatomic reduction and stable fixation of all injured structures.
Diagnosis and therapy of acute scaphoid fractures are primarily aimed at the prevention of nonunion and arthritic carpal collapse with painful impairment of the wrist function. To achieve this, the S3-level guideline contains explicit recommendations.
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