Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment
Seyit Ali Gümüştaş, Haci Bayram Tosun, İsmail Ağır, Abuzer Uludağ
(Department of Orthopaedics and Traumatology, Adiyaman Education and Research Hospital, Adıyaman, Turkey)
Am J Case Rep 2014; 15:139-142
Background: Carpal fractures often appear in men under the age of 40 years. Isolated fracture of the capitate without dislocation is very rare and comprises 1% of all carpal fractures. Nonunion of capitate mostly resulted from delay in diagnosis and lack of initial treatment.
Case Report: We reported the case of a 13-year-old boy who had a late-diagnosed capitate fracture. We put the wrist in a short-arm cast for 3 months. After the immobilization with the cast has been finalized, range of motion and strengthening exercises were started. One year after the trauma, we saw total union of the fracture.
Conclusions: Diagnosis of carpal bone fracture may be missed, especially in skeletally immature patients. To prevent late diagnosis in skeletally immature patients, early control radiography should be taken. If further examination is needed, computed tomography should be performed. We can achieve good results with cast immobilization in this age group of patients. As a result, although the author has been advised surgical treatment for nonunion of capitate fracture, conservative treatment should be considered.
Keywords: Capitate Bone, nonunion, Carpal Bones - injuries