Trapezium fracture
Citation, DOI, disclosures and article data
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Mostafa Elfeky had no financial relationships to ineligible companies to disclose.
View Mostafa Elfeky's current disclosures- Trapezium fractures
- Fractures of the trapezium
- Fracture of the trapezium
- Fracture of trapezium
Trapezium fractures are uncommon carpal bone injuries. They can either occur in isolation or combination with another carpal bony injury.
On this page:
Epidemiology
Isolated fractures of the trapezium are only thought to account for 3-5% of all carpal fractures 1,2.
Pathology
They can be broadly classified into ridge (most common 2) and body fractures.
Mechanism
They often occur as a result of a high energy trauma and usually involve either direct or indirect axial loading 1. These are most commonly transverse loading injuries in the setting of an adducted thumb in which the first metacarpal is driven into the trapezium 5.
Trapezial ridge fractures may result from a direct blow to the volar surface, dorsoradial impaction or an avulsion injury. Fractures of the trapezial body result from an axial loading or shearing force through the first carpometacarpal joint.
Associations
Trapezial fractures are often associated with a fracture of the first metacarpal base and/or subluxation or dislocation of the first carpometacarpal joint.
Trapezial ridge fractures may be associated with wrist injuries, including distal radial fractures.
Radiographic features
General
Non displaced fractures can sometimes be occult. A Robert’s AP view, with the hand in full pronation, is a good way of visualizing the trapezium on plain radiographs. If the diagnosis is still in question, a CT or bone scintigraphy could be considered.
Trapezial ridge fractures may be overlooked at routine wrist radiography. Carpal tunnel radiographs may be helpful to detect this fracture 2, whereas CT imaging can be diagnostic.
Treatment and prognosis
Displaced fractures may require open reduction and internal fixation, typically performed with Kirschner wires or screws.
Differential diagnosis
If corticated, consider accessory ossicles in this region such as
See also
References
- 1. Ramoutar DN, Katevu C, Titchener AG et-al. Trapezium fracture - a common technique to fix a rare injury: a case report. Cases J. 2009;2 : 8304. doi:10.4076/1757-1626-2-8304 - Free text at pubmed - Pubmed citation
- 2. Kaewlai R, Avery LL, Asrani AV et-al. Multidetector CT of carpal injuries: anatomy, fractures, and fracture-dislocations. Radiographics. 2008;28 (6): 1771-84. doi:10.1148/rg.286085511 - Pubmed citation
- 3. Wiesler ER, Chloros GD, Kuzma GR. Arthroscopy in the treatment of fracture of the trapezium. Arthroscopy. 2007;23 (11): 1248.e1-4. doi:10.1016/j.arthro.2006.07.051 - Pubmed citation
- 4. Schmitt R, Lanz U. Diagnostic Imaging of the Hand. George Thieme Verlag. (2008) ISBN:3131405813. Read it at Google Books - Find it at Amazon
- 5. Goldfarb CA et.al. Wrist Fractures: What the Clinician Wants to Know1. Radiology. 2001;219 (1): 11-28. Radiology (full text)
Incoming Links
Related articles: Fractures
-
fracture
- terminology
- fracture location
- diaphyseal fracture
- metaphyseal fracture
- physeal fracture
- epiphyseal fracture
- fracture types
- avulsion fracture
- articular surface injuries
- complete fracture
- incomplete fracture
- infraction
- compound fracture
- pathological fracture
- stress fracture
- fracture displacement
- fracture location
- fracture healing
- skull fractures
-
facial fractures
- fractures involving a single facial buttress
- alveolar process fractures
- frontal sinus fracture
- isolated zygomatic arch fractures
- mandibular fracture
- nasal bone fracture
- orbital blow-out fracture
- paranasal sinus fractures
- complex fractures
- dental fractures
- fractures involving a single facial buttress
-
spinal fractures
- classification (AO Spine classification systems)
-
cervical spine fracture classification systems
- AO classification of upper cervical injuries
- AO classification of subaxial injuries
- Anderson and D'Alonzo classification (odontoid fracture)
- Roy-Camille classification (odontoid process fracture)
- Gehweiler classifcation (atlas fractures)
- Levine and Edwards classification (hangman fracture)
- Allen and Ferguson classification (subaxial spine injuries)
- subaxial cervical spine injury classification (SLIC)
- thoracolumbar spinal fracture classification systems
- three column concept of spinal fractures (Denis classification)
- classification of sacral fractures
-
cervical spine fracture classification systems
- spinal fractures by region
- spinal fracture types
- classification (AO Spine classification systems)
- rib fractures
- sternal fractures
-
upper limb fractures
- classification
- Rockwood classification (acromioclavicular joint injury)
- AO classification (clavicle fracture)
- Neer classification (clavicle fracture)
- Neer classification (proximal humeral fracture)
- AO classification (proximal humeral fracture)
- AO/OTA classification of distal humeral fractures
- Milch classification (lateral humeral condyle fracture)
- Weiss classification (lateral humeral condyle fracture)
- Bado classification of Monteggia fracture-dislocations (radius-ulna)
- Mason classification (radial head fracture)
- Frykman classification (distal radial fracture)
- Mayo classification (scaphoid fracture)
- Hintermann classification (gamekeeper's thumb)
- Eaton classification (volar plate avulsion injury)
- Keifhaber-Stern classification (volar plate avulsion injury)
- upper limb fractures by region
- shoulder
- clavicular fracture
-
scapular fracture
- acromion fracture
- coracoid process fracture
- glenoid fracture
- humeral head fracture
- proximal humeral fracture
- humeral neck fracture
- arm
- elbow
- forearm
- wrist
-
carpal bones
- scaphoid fracture
- lunate fracture
- capitate fracture
- triquetral fracture
- pisiform fracture
- hamate fracture
- trapezoid fracture
- trapezium fracture
- hand
- shoulder
- classification
- lower limb fractures
- classification by region
- pelvic fractures
- hip fractures
- Pipkin classification (femoral head fracture)
- Garden classification (hip fracture)
- American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture)
- Cooke and Newman classification (periprosthetic hip fracture)
- Johansson classification (periprosthetic hip fracture)
- Vancouver classification (periprosthetic hip fracture)
- femoral
- knee
- Schatzker classification (tibial plateau fracture)
- AO classification of distal femur fractures
- Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture)
- tibia/fibula
- Watson-Jones classification (tibial tuberosity avulsion fracture)
- ankle
- foot
- Berndt and Harty classification (osteochondral lesions of the talus)
- Sanders CT classification (calcaneal fracture)
- Hawkins classification (talar neck fracture)
- Myerson classification (Lisfranc injury)
- Nunley-Vertullo classification (Lisfranc injury)
- pelvis and lower limb fractures by region
- pelvic fracture
- sacral fracture
- coccygeal fracture
-
hip
- acetabular fracture
- femoral head fracture
-
femoral neck fracture
- subcapital fracture
- transcervical fracture
- basicervical fracture
-
trochanteric fracture
- pertrochanteric fracture
- intertrochanteric fracture
- subtrochanteric fracture
- femur
- mid-shaft fracture
- bisphosphonate-related fracture
- distal femoral fracture
- knee
- avulsion fractures
- Segond fracture
- reverse Segond fracture
- anterior cruciate ligament avulsion fracture
- posterior cruciate ligament avulsion fracture
- arcuate complex avulsion fracture (arcuate sign)
- biceps femoris avulsion fracture
- iliotibial band avulsion fracture
- semimembranosus tendon avulsion fracture
- Stieda fracture (MCL avulsion fracture)
- patellar fracture
- tibial plateau fracture
- avulsion fractures
- leg
- tibial tuberosity avulsion fracture
- tibial shaft fracture
- fibular shaft fracture
- Maisonneuve fracture
- ankle
- foot
- tarsal bones
- metatarsal bones
- phalanges
- classification by region
- terminology
Related articles: Wrist pathology
- alignment
- wrist fractures and dislocations
- distal radial fracture
- pediatric
- carpal bones
- Mayfield classification of carpal instability
- carpal instability
- osteonecrosis
- triangular fibrocartilaginous complex (TFCC) injuries
- ulnar-sided wrist impaction and impingement syndromes
- soft tissue and tendons
- arthritides