[Pseudarthrosis of the capitate].

A 54 years old railway engine-driver fell on his extended right hand in November 1978. In the next few hours he developed increasing pain. He reported similar slight trauma some fourteen months before, but without pain. The tomographic X-ray examination proved the presence of an isolated non-union of the capitate with some shortening. Four days after the second accident an autologous graft was performed following the technique of Matti. The non-union healed after three months in a plaster cast, and the patient returned to full work after four months. Examining him four years and nine months later, the patient complained about persisting pain when stressed. The mobility of the wrist was moderately reduced, and the healed capitate showed unchanged shortening. Isolated non-unions of the capitate can, therefore, be painless for a long time--a situation well-known with scaphoid non-unions. Considering the operative technique, a cancellous graft alone is not able to restore the function of the wrist because of associated collapse of the carpus. To obtain a better late result, the length of the capitate ought to be restored and a cortico-spongious graft inserted.