Bahadır Can Dağdelen

Ankara Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye

Dağdelen BC. Carpal Bone Fractures: Classification and Treatment Options. In: Tiftikçi U, Erdoğan E, Ergün C, Güneş Z, editors. Current Concepts in Adults Upper Extremity Fractures. 1^st ed. Ankara: Türkiye Klinikleri; 2025. p.305-311.

ABSTRACT

The term “carpal” is derived from the Latin word “carpus” and is used to denote the area between the “forearm and wrist”. The term “carpal bones” is a collective designation for a series of eight bones. Of these, there are four in each of the proximal and distal rows. The proximal row comprises the lateral to medial scaphoid, lunate, triquetrum, and pisiform. The distal row consists of the lateral to medial trapezium, trapezoideum, capitatum and hamatum. The principal function of these bones, situated between the metacarpal bones and the radius and ulna bones in the hand, is to facilitate wrist function. The anatomical integrity of the carpal bones and their harmonious interrelation are pivotal for the maintenance of normal wrist function. It is noteworthy that the incidence of carpal bone fractures is comparatively lower when compared to other bone fractures. However, the scaphoid bone, a constituent of the carpal bones, exhibits a distinct pattern. Indeed, scaphoid fractures are more prevalent than other carpal bone fractures. The mechanism of carpal bone fractures is hyperextension; however, it is important to note that fractures may rarely occur with hyperflexion or direct trauma. A detailed history and clinical examination are imperative in patients presenting with wrist pain, swelling and limitation of movement. As carpal bone fractures are frequently under-diagnosed, standard radiographic imaging should be performed in patients presenting with these symptoms. In cases where the diagnostic utility of standard radiography is uncertain, a detailed examination with computed tomography (CT) may be required. Carpal bone fractures, if not correctly diagnosed and treated, can lead to serious complications, chronic pain and functional limitations. While these complications can be prevented with a thorough medical history, detailed physical examination and imaging, complications may still develop depending on the location and blood supply of the carpal bones. The most significant complication is avascular necrosis, which is attributable to the anatomical and blood supply characteristics of the carpal bones. In cases of untreated or delayed carpal bone fractures, impaired blood supply is a potential outcome. The present study commences with a presentation of information regarding the anatomy of the carpal bones, followed by an examination of the mechanisms underpinning fractures within these bones. The subsequent sections of the study will address current treatment methods for carpal bone fractures and the potential complications that may arise during the treatment stages of fractures.

Keywords: Carpal bones; Wrist; Scaphoid bone complications; Hamate bone