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Trapezium Fracture

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Other Names

  • Trapezium Fracture dislocation

Background


Pathophysiology


Risk Factors

  • Unknown

Differential Diagnosis

Carpal Bone Fractures

Differential Diagnosis Wrist Pain


Clinical Features


Evaluation

Radiographs

CT

  • Better evaluate fracture pattern

Classification

  • Vertical intra-articular[2]
  • Horizontal
  • Dorsal radial tuberosity
  • Anterior medial ridge
  • Comminuted

Management

Nonoperative

  • Management generally driven by degree of displacement
  • Indications
    • Non-displaced
  • Cast: Thumb Spica Cast for 4-6 weeks

Operative

  • Indications
    • Displaced fractures
    • Fracture-dislocation
  • Technique
    • Percutaneous Kirschner wire fixation
    • Oblique external traction
    • Open reduction and internal fixation

Return to Play

  • Dictated by physician
  • On average 4-6 weeks

Complications

  • Trapeziometacarpal arthritis
  • Scaphotrapezium-trapezoid arthritis
  • Nonunion
  • Malunion
  • Carpometacarpal Arthritis
  • Carpal Tunnel Syndrome
  • Flexor Carpi Radialis tendinopathy with late rupture
  • Painful loss of pinch strength and function

See Also


References

  1. Pointu J, Schwenck JP, Destree G, Sejourne P. [Fractures of the trapezium: mechanisms, anatomo-pathology and therapeutic indications]. Rev Chir Orthop Reparatrice Appar Motil. 1988;74(5):454e465.
  2. Walker JL, Greene TL, Lunseth PA. Fractures of the body of the trapezium. J Orthop Trauma. 1988;2(1):22e28.
Created by:
John Kiel on 18 June 2019 22:56:34
Authors:
Last edited:
13 October 2022 21:42:50
Categories:
Trauma | Osteology | Wrist | Upper Extremity | Fractures | Acute