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# Capitate

The capitate is the largest wrist bone, in the centre of the second row; wrist motion pivots around its rounded head.

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## What it is

The largest wrist bone, in the middle of the hand's base.

## What it does

One of the eight carpal bones that let the wrist bend and carry load to the forearm.

## Key points

- The [axis](https://durgical.com/en/anatomy/axis/) of wrist motion runs through its head, which sits in the cup of the lunate
- Its blood supply enters distally, so a fracture through the neck can leave the head without blood, as in the scaphoid
- Scaphocapitate syndrome: a rare combined fracture of the scaphoid and the capitate neck in which the capitate head turns upside down

## Key facts

**Joints with**
Scaphoid, lunate, trapezoid, hamate, 2nd–4th metacarpals

**Landmarks**
Head; largest carpal bone, ossifies first

## Relations

**Above**
Head in the concavity of the [lunate](https://durgical.com/en/anatomy/lunate/), with the [scaphoid](https://durgical.com/en/anatomy/scaphoid/) alongside

**Below**
Bases of the 2nd, 3rd and 4th metacarpals, mainly the 3rd

**Lateral**
Scaphoid and [trapezoid](https://durgical.com/en/anatomy/trapezoid/)

**Medial**
[Hamate](https://durgical.com/en/anatomy/hamate/), joined by a strong interosseous ligament

**In front**
Floor of the [carpal tunnel](https://durgical.com/en/anatomy/carpal-tunnel/) under the [median nerve](https://durgical.com/en/anatomy/median-nerve/) and flexor tendons; origin of the oblique head of the [adductor pollicis](https://durgical.com/en/anatomy/adductor-pollicis/)

## How to find it

On the back of the hand it lies in a slight hollow just proximal to the base of the [3rd metacarpal](https://durgical.com/en/anatomy/3rd-metacarpal/), in line with the middle finger; with the wrist flexed the head is felt just distal to the lunate.

## On imaging

On the lateral view the [radius](https://durgical.com/en/anatomy/radius/), lunate and capitate form a straight column; a capitate displaced dorsally behind a lunate that stays with the radius means perilunate dislocation. On the PA view the third Gilula arc runs along the proximal capitate and hamate.

## Clinical notes

- Isolated fractures are uncommon and usually part of a greater arc perilunate injury
- Avascular necrosis of the head can follow a neck fracture or occur without trauma
- It is one of the four bones joined in a four-corner fusion (with the lunate, hamate and [triquetrum](https://durgical.com/en/anatomy/triquetrum/)), an operation for advanced SLAC or SNAC wrist after the scaphoid is removed

## Development

The first carpal bone to ossify, in the first months of life, followed by the hamate; the rest appear roughly one per year: triquetrum, lunate, scaphoid, [trapezium](https://durgical.com/en/anatomy/trapezium/), trapezoid, and last the [pisiform](https://durgical.com/en/anatomy/pisiform/). Counting carpal centres gives a rough bone age.

## Test yourself

Think of the answer, then tap the question to see it.

## Which is the first carpal bone to ossify?

The capitate, in the first months of life, followed by the hamate.

## Why can a fracture through the neck of the capitate leave its head without blood?

Its blood supply enters distally, as in the scaphoid.

## What is scaphocapitate syndrome?

A rare combined fracture of the scaphoid and the capitate neck in which the capitate head turns upside down.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
os capitatum TA2 1258

**Official Spanish (DeCS)**
Hueso grande

**English (TA2)**
Capitate

## Related

- [Adductor pollicis](https://durgical.com/en/anatomy/adductor-pollicis/)
- [CMC ligaments](https://durgical.com/en/anatomy/carpometacarpal-and-metacarpal-ligaments/)
- [Dorsal intercarpal ligament](https://durgical.com/en/anatomy/dorsal-intercarpal-ligament/)
- [Extensor tendons](https://durgical.com/en/anatomy/extensor-digitorum-tendons/)
- [Midcarpal ligaments](https://durgical.com/en/anatomy/midcarpal-and-intercarpal-ligaments/)
- [Palmar wrist ligaments](https://durgical.com/en/anatomy/palmar-radiocarpal-ligaments/)
- [Scapholunate ligament](https://durgical.com/en/anatomy/scapholunate-interosseous-ligament/)
- [Ulnocarpal ligaments](https://durgical.com/en/anatomy/ulnocarpal-ligaments/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Hand Carpal Bones](https://www.ncbi.nlm.nih.gov/books/NBK535382/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/capitate/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/capitate/