Nederlands tijdschrift voor geneeskunde · 2013
[An occult fracture of the capitate bone].
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Zoakman Sahel, Rhemrev Steven J
Аннотация
BACKGROUND: Evaluating patients with wrist injuries is diagnostically challenging. Physical examination alone is not sufficient for establishing a diagnosis and fractures of the wrist region are not always visible on x-rays.
CASE DESCRIPTION: In this article, we present a case of a patient who had sustained trauma to the wrist and was taken care of at the emergency department. The mechanism of trauma and clinical findings strongly indicated a fracture of the scaphoid bone. No abnormality was visible on x-rays; the fracture was treated by casting nonetheless. On a CT scan performed later, there indeed appear to be a non-dislocated fracture of the capitate bone present. The diagnosis was confirmed by bone scintigraphy a few days later. The patient recovered without complications.
CONCLUSION: Fractures of the capitate bone are serious carpal injuries that must be treated as aggressively as fractures of the scaphoid bone. Conventional radiological examinations cannot rule out a fracture of the wrist; if doubt persists, readily accessible imaging techniques (such as CT or MRI) should be conducted.
CASE DESCRIPTION: In this article, we present a case of a patient who had sustained trauma to the wrist and was taken care of at the emergency department. The mechanism of trauma and clinical findings strongly indicated a fracture of the scaphoid bone. No abnormality was visible on x-rays; the fracture was treated by casting nonetheless. On a CT scan performed later, there indeed appear to be a non-dislocated fracture of the capitate bone present. The diagnosis was confirmed by bone scintigraphy a few days later. The patient recovered without complications.
CONCLUSION: Fractures of the capitate bone are serious carpal injuries that must be treated as aggressively as fractures of the scaphoid bone. Conventional radiological examinations cannot rule out a fracture of the wrist; if doubt persists, readily accessible imaging techniques (such as CT or MRI) should be conducted.