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Case Reports
. 2024 Apr 16;16(1):100021.
doi: 10.1055/s-0043-1761224. eCollection 2024 Mar.

Capitate Fracture Subsequent to Capitolunate Staple Fusion: A Case Report

Anna Zakusylo  1 , Jared A Escobar  1 , Gregory R Toci  2 , Michael N Nakashian  3 , Daniel Fletcher  2 , Brian M Katt  1   3
Affiliations
Case Reports

Capitate Fracture Subsequent to Capitolunate Staple Fusion: A Case Report

Anna Zakusylo et al. J Hand Microsurg. .

Abstract

We report a case of a 71-year-old man who underwent capitolunate fusion for scapholunate advanced collapse. At the patient's 4-month follow-up, there was evidence of a fracture at the distal staple tine. He subsequently underwent removal of staple hardware with revision open reduction internal fixation using headless compression screw fixation and bone grafting. The literature review aimed to identify possible mechanisms and analyze similar cases of this complication. We presume that the fracture resulted from increased stress on the bone from both drill holes and the orientation of the staples. Placing the tines in different planes may decrease the risk of this complication.

Keywords: capitate; complications; surgery; wrist.

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Figures

Fig. 1
Fig. 1
(A) Preoperative anterior–posterior film of SLAC. (B) Preoperative lateral film of SLAC. November 2020. SLAC, scapholunate advanced collapse.
Fig. 2
Fig. 2
(A) Postoperative anterior–posterior film of staple placement in the capitate and lunate resulting in capitolunate fusion with scaphoid resection. The fusion site appears healthy with no evidence of hardware loosening. (B) Postoperative lateral film of capitolunate fusion. Inconclusive evidence of fracture at the distal staple tine.
Fig. 3
Fig. 3
(A) Anterior–posterior film of capitolunate fusion with staple fixation. There is possible evidence of a fracture at the distal staple tine through the capitate or loosening. (B) Lateral film of capitolunate fusion. (C) Oblique film of capitolunate fusion. April 2021.
Fig. 4
Fig. 4
(A) CT imaging of coronal plane with adequate capitolunate fusion, and there is no further gap and evidence of a nondisplaced fracture at the distal staple tine through the capitate. (B) CT imaging of sagittal plane with fracture through the capitate. April 2021. CT, computed tomography.
Fig. 5
Fig. 5
(A) Postoperative anterior–posterior film with headless compression screws in good position through the capitate and has acceptable alignment of the fracture. (B) Postoperative lateral film of headless compression screws. August 2021.
See this image and copyright information in PMC

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References

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