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Triquetrum Fracture

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Other Names

  • Triquetral Fracture

Background

  • Triquetrum is the second most common carpal fracture behind Scaphoid[1]
  • Accounts for 15% of all carpal fractures

Pathophysiology


Risk Factors

  • Unknown

Differential Diagnosis

Carpal Bone Fractures

Differential Diagnosis Wrist Pain


Clinical Features

  • General: Physical Exam Wrist
  • Swelling, bruising, pain at distal wrist, typically over ulnar side
  • Pain with direct palpation of triquetrum

Evaluation

Radiographs

MRI

  • Useful for palmar cortical fractures
  • Can evaluate for other soft tissue pathology

CT

  • Useful for assessing fracture fragments, extend of collapse, pre-operative planning

Classification

  • Dorsal cortical fractures[2]
    • >90%
    • Mechanism: Avulsion, shearing, impaction
  • Body fractures
    • Second most common
    • Multiple subtypes
  • Palmar cortical fractures
    • Mechism: avulsion, shering force
    • Higher risk of instability

Management

Nonoperative

  • Indications:
    • Dorsal cortical fracture without carpal instability
    • Nondisplaced body fractures
    • Palmar cortical fracture without carpal instability
  • Cast: Short Arm Cast
  • Immobilize for 4-6 weeks

Operative

  • Indications:
    • Dorsal cortical fracture with carpal instability
    • Displaced body fractures
    • Palmar cortical fracture with carpal instability

Return to Play

  • 6 to 8 weeks

Complications

  • Nonunion
  • Carpal Instability
  • Pisotriquetral arthritis

See Also


References

  1. Suh N, Ek ET, Wolfe SW. Carpal fractures. J Hand Surg Am. 2014 Apr;39(4):785-91; quiz 791. doi: 10.1016/j.jhsa.2013.10.030. Review. PubMed PMID: 24679911.
  2. https://www.orthobullets.com/hand/322147/triquetrum-fracture
Created by:
John Kiel on 18 June 2019 22:56:39
Authors:
Last edited:
13 October 2022 21:42:13
Categories:
Trauma | Osteology | Wrist | Upper Extremity | Fractures | Acute