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Capitate

os capitatum

The capitate is the largest carpal bone and occupies the centre of the wrist, forming the keystone of the distal carpal row and serving as the main articulation for the third metacarpal. Its central position means virtually all wrist movements involve it.

Anatomical Data

Structure & Landmarks

Articulations	Lunate proximally Second, third, and fourth metacarpals distally Scaphoid laterally Hamate medially Trapezoid laterally
Landmarks	Head Neck Body
Ossification	Endochondral ossification from a single centre, the first carpal bone to begin ossification, appearing at 1 month of postnatal age.

Clinical Relevance

Clinical Notes

The capitate is the largest carpal bone and the central keystone of the carpus, forming the primary articulation with the third metacarpal base and the central pivot of wrist motion. Perilunate dislocations typically involve the capitolunate interval as the primary failure point. Capitate fractures are rare and usually occur as part of the scaphocapitate syndrome (scaphoid fracture combined with capitate fracture through the neck).

Pathology

Common Injuries & Conditions

Capitate Fracture

Usually occurs with a scaphoid fracture as part of a greater arc injury (scaphocapitate syndrome); the proximal pole may rotate and undergo avascular necrosis.

Carpal Boss

A bony prominence at the base of the second and third metacarpals and adjacent capitate and trapezoid causes a painful lump on the back of the hand.

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