Trapezium fracture

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Trapezium fracture
Trapezium-fracture-2.png
Undisplaced fracture of the right trapezium
SpecialtyHand surgery
SymptomsPain at the base of the thumb and with thumb movement[1][2]
ComplicationsArthritis, carpal tunnel syndrome, wrist stiffness[3]
TypesBody, trapezial ridge, fracture dislocations[3]
CausesForces transmitted through the thumb, being pulled upon by the transverse carpal ligament[3]
Diagnostic methodX-ray, CT scan[3]
Differential diagnosisOs paratrapezium[4]
TreatmentCasting, surgery[3]
PrognosisGenerally good[3]
Frequency4% of wrist fractures[2]

Trapezium fracture is a break of the trapezium bone in the wrist. Symptoms typically include pain at the palm side of the wrist at the level of the thumb.[1] There is also typically pain with thumb movement.[2] Often there are other wrist bone fractures.[3] Complications may include arthritis, carpal tunnel syndrome, and wrist stiffness.[3]

The typically result from forces transmitted through the thumb, or being pulled upon by the transverse carpal ligament.[3] Types include body, trapezial ridge, and fracture dislocations.[3] Diagnosis is generally by X-ray or CT scan.[3]

If the peices are well aligned an orthopedic cast, specifically a thumb spica for 4 to 6 weeks may be used.[3] Otherwise surgery is typically required.[3] Outcomes are generally good with appropriate treatment.[3] Trapezium fractures represent about 1 to 5% of breaks of bones within the wrist.[3]

Diagnosis

The fracture may be best seen on an oblique wrist X-ray, but some may not be visible on plain X-ray.[3] Carpal tunnel views or CT scan can be useful in unclear cases.[4]

References

  1. 1.0 1.1 Doral, Mahmut Nedim; Karlsson, Jón; Nyland, John; Benedetto, Karl Peter (15 May 2019). Intraarticular Fractures: Minimally Invasive Surgery, Arthroscopy. Springer. p. 198. ISBN 978-3-319-97602-0. Archived from the original on 27 September 2022. Retrieved 24 September 2022.
  2. 2.0 2.1 2.2 Walls, Ron; Hockberger, Robert; Gausche-Hill, Marianne (9 March 2017). Rosen's Emergency Medicine - Concepts and Clinical Practice E-Book. Elsevier Health Sciences. ISBN 978-0-323-39016-3. Archived from the original on 27 September 2022. Retrieved 24 September 2022.
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 Suh, Nina; Ek, Eugene T.; Wolfe, Scott W. (April 2014). "Carpal Fractures". The Journal of Hand Surgery. 39 (4): 785–791. doi:10.1016/j.jhsa.2013.10.030.
  4. 4.0 4.1 Weerakkody, Yuranga. "Trapezium fracture | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Archived from the original on 1 February 2022. Retrieved 24 September 2022.

External links