Idiopathic Avascular Necrosis of the Capitate — A Case Report and a Review of the Literature

Abstract

Avascular necrosis (AVN) of the capitate is a rare condition. A case report is presented with a review of the literature.

Long-Term Follow-Up of a Vascularized Metacarpal Bone Graft in the Treatment of Idiopathic Avascular Necrosis of the Capitate

“…Avascular necrosis of the capitate is rare and typically occurs after direct trauma, such as a fracture of the waist of the capitate associated with a scaphoid fracture, naviculocapitate syndrome or repeated minor injuries (6)(7)(8). In addition, idiopathic causes have been reported (1)(2)(3)(4).…”

“…Various nonsurgical and surgical treatment options have been described. The former include plaster casts or splints, which were subsequently shown not to be effective (4). Surgical treatment has, to date, consisted of autogenous bone grafting and drilling (8), resection and interposition with a palmaris longus tendon or a fourth toe extensor tendon (1), a silicone prosthesis (7), and midcarpal or scaphocapitolunate arthrodesis (2,6).…”

“…I diopathic avascular necrosis of the capitate is rare and few case reports have been published (1)(2)(3)(4). The treatments described in the literature consist of resection arthroplasty using a tendon graft (1), intercarpal arthrodesis (2), vascularized bone graft (3) and splinting (4).…”

A case of avascular necrosis of capitate bone in an air compressor jack hammer worker

“…Based on the published reports, several occupations have shown association with AVN of capitate bone including carpenters, pallet car drivers, construction laborers, bus conductors, warehousemen, pneumatic tool users, and vibrating tool users. 3,4,7 Our patient was exposed to continuous vibration pressure of air compressor jack hammer which resulted in AVN in capitate bone; this is the first report on the relationship of the mentioned job with this disease. In the first stages, before bone changes, changing the job and wrist immobilization by splint could be helpful in controlling the symptoms.…”

Behandlung der verzögerten Heilung bei isolierter Kapitatumfraktur

“…Das Kapitatum wird haupts ä chlich durch Gef ä ß e versorgt, die von palmar und dorsal in den Knochen eintreten [20] und retrograd den proximal rosen des Kapitatums ohne avaskul ä re Knochennekrosen des proximalen Fragmentes [21] . W ä hrend frische undislozierte Kapitatumfrakturen durch Ruhigstellung im Unterarm-Gips zur Ausheilung gebracht werden k ö nnen [2] , ist die konservative Behandlung bei verz ö gerter Knochenheilung, Pseudarthrosen und avaskul ä ren Knochennekrosen nicht empfehlenswert [12] . Daf ü r stehen verschiedene operative Verfahren mit Resektion der Pseudarthrose und Stabilisierung des Kapitatums durch unterschiedliche Osteosyntheseverfahren zur Verf ü gung.…”