Successful delayed surgical treatment of a scaphocapitate fracture

The scaphocapitate fracture syndrome is a rare entity of a perilunate fracture-dislocation. The diagnosis is frequently missed at initial presentation to a physician. Usually, a CT scan is required to reveal the extent of the lesion. Operative treatment consists of open reduction and internal fixation with screws (e.g. headless compression screw) or Kirschner wires. We report on a case of a 19-year-old man who presented to our hospital 2 months after he fell on his left wrist. He complained about persistent pain and a decreased range of motion after conservative treatment in a short arm cast. The diagnosis was finally made by a CT scan and the patient was treated operatively using headless compression screws in both the capitate and the scaphoid. After 12 weeks, fractures were completely healed radiographically and the patient returned to work. At follow-up 16 months after trauma, the patient had no further complaints. Range of motion increased and no avascular necrosis could be observed.