Fractures of the carpus

The carpus is a complex joint, consisting of seven bones arranged in two rows, with multiple ligamentous supports originating from, inserting on and connecting the bones. Individual fractures of the bones of the carpus are rare, and, due to the small size of some bones, repair may not be possible. For the larger carpal bones, repair is indicated where fragments are large enough and especially if the fracture is articular. Several methods of repair are suitable, although compression of the fragments using lag screws or headless, self-compressing cannulated screws is often ideal. Where the fragments are too small, removal may be advised and external coaptation is often used in conjunction. For non-repairable fractures of the articular surfaces, and other carpal injuries precluding primary repair, partial carpal arthrodesis or pancarpal arthrodesis may be considered as salvage procedures. The prognosis for recovery from carpal fractures depends on the type of injury, the bone affected, the method of repair a...