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FIGURE 109.14 Radiographs demonstrating carpometacarpal dislocation. (Courtesy of
Children’s Orthopaedic Surgery Foundation.)

Clinical Considerations
Clinical Recognition
The incidence of carpal fractures is relatively low in children, although increasing
awareness has led to improved recognition. In infancy, the carpals are completely
cartilaginous and are nearly immune to injury. They progressively ossify
beginning with the capitate. The scaphoid is by far the most common fractured
carpal bone, with most fractures occurring in late childhood and adolescence.
Falls are the most frequent cause.