Arthroscopic Treatment of Capitate Nonunion: A New Technique

Isolated fractures of the capitate are very rare which means that their nonunion is even rarer. Repair techniques have always been performed by open surgery which may result in loss of mobility due to the capsulotomy. The typically used surgical techniques such as arthrodesis of the carpal or wrist bones can have irreversible consequences on range of motion. No arthroscopic technique has ever been described for this condition. Here, we describe a case of isolated capitate nonunion without ligament tears or other carpal fractures in a 21-year-old male, following a capitate fracture 10 years prior. We describe our arthroscopic treatment technique for this capitate nonunion.

A Unique Presentation of Scaphocapitate Syndrome With Extrusion Into the Carpal Tunnel: A Case Report

Background: Scaphocapitate syndrome is a rare variety of perilunate instability, described as a trans-scaphoid, trans-capitate fracture, with rotation of the capitate head either 90° or 180°. Methods: We present a unique case of scaphocapitate syndrome in which the rotated proximal capitate fragment expelled into the carpal canal. Results: The capitate head was extricated from the carpal tunnel via the volar approach, and was anatomically aligned and fixed through the dorsal approach using two 2.0 mm headless compression screws. The scaphoid fracture was then also reduced through the dorsal approach and stabilized with a 2.5 mm headless compression screw. All intercarpal ligaments appeared intact. Conclusions: Volar dislocation of the proximal capitate into the carpal tunnel in scaphocapitate syndrome presents a unique challenge that can be addressed with a combined volar and dorsal approach.