Isolated Complete Volar Dislocation of the Capitate: A Case Report

Abstract

Total dislocation of the capitate is an extremely rare event. We report on one such unusual case. The complete expulsion of the capitate from its physiological position is difficult to diagnose. Standard parameters of the antero-posterior and lateral radiological do not head to a definite diagnosis. In our patient, the only real diagnostic tool was the clinical assessment and the Gilula arches alteration to the standard antero-posterior projection. In the period following trauma, the patient reported a very high level of pain in the wrist. Since this could not be correlated to the lesions that had been diagnosed, we hypothesized the presence of any carpal bones damage. A definite diagnosis was obtained at CT scan, which also revealed the absence of any fractures.

Volar Capitate Dislocation: A Case Report

“…Checcucci et al reported isolated complete volar dislocation of the capitate associated with flexor and extensor tendon lacerations. Unlike this case, there was no residual soft tissue attachment to the capitate [1].…”

Isolated Open Dislocation of the Capitate

“…It is possible that the mechanism and direction of dislocation is different for isolated and combined capitate dislocations. Similar to Checcucci et al 2 , we present a successful treatment option for an isolated capitate injury that involves prompt open reduction and stabilization of the capitate with the usage of K-wires. Previous reports have also advocated median nerve decompression, given that most capitate dislocations are palmar with the involvement of the carpal tunnel 5 .…”

“…A fter review of the literature, our case may represent the first isolated open capitate dislocation in the literature and only the second reported case of an isolated capitate dislocation. The case presented by Checcucci et al 2 was also a palmar dislocation and was caused by a high impact crush injury from a mechanical press. Our case also resulted from a high-energy crush injury.…”

“…solated carpal dislocations represent a rare wrist injury and as such may have delays in diagnosis and treatment. Although all carpal bones have been reported to dislocate in an isolated fashion, an isolated capitate dislocation has only been described once in the literature, with no previous reports of open capitate dislocations 1,2 . Even with other concomitant wrist injuries, there have only been a few reports of capitate dislocations [3][4][5] .…”

“…Awareness of these injuries will lead to prompt diagnosis and surgical treatment to minimize disability. n Tyler Janish, BS 1 Robert Blotter, MD 2 1 Michigan State University College of Human Medicine, East Lansing, Michigan 2 Advanced Center for Orthopedics and Plastic Surgery, Marquette, Michigan E-mail address for T. Janish: janishty@msu.edu…”