ePlasty: Vol. 17
Avascular Necrosis of the Capitate
David Buziashvili, MBS,a Richard S Zeri, MD, FACS,b and Tom Reisler, MB ChB, BSc(Hons), MRCS(Ed)b

aNew Jersey Medical School, Rutgers University, Newark bDivision of Plastic and Reconstructive Surgery, Department of Surgery, The Brody School of Medicine, East Carolina University, Greenville, NC


Correspondence: tomre13@yahoo.com
Keywords: avascular necrosis, osteonecrosis, capitate bone, Milliez classification, vascular supply carpus

DESCRIPTION

A 41-year-old woman, right-hand-dominant hairdresser who was a smoker, presented with right wrist pain. Weeks prior to the magnetic resonance imaging (MRI) study, the patient was prescribed a course of oral prednisone for “arthritic pain.” No history of major trauma or inflammatory disease was reported.

QUESTIONS

1. What are the causes and predisposing factors to avascular necrosis (AVN) of the capitate?

2. What is the radiological classification of AVN of the capitate?

3. What are the signs and symptoms of this condition?

4. What are the nonsurgical and surgical treatments available for AVN of the capitate ?

DISCUSSION

Avascular necrosis of the capitate is extremely rare, with only 48 cases reported in the literature up to 2012.1 Trauma or repeated microtrau .......