Trapezium

Last revised by Joshua Yap on 3 Apr 2024

The trapezium (also known as the greater multangular) is one of the eight carpal bones of the hand. It is the most lateral (radial) bone of the distal row, located between the scaphoid and the first metacarpal bone. It articulates with the scaphoid proximally, the trapezoid medially, and the thumb and index metacarpals distally. The trapezium and trapezoid are collectively known as the multangulars.

The trapezium has six surfaces in total:

  1. rough palmar surface which contains a medial groove and prominent tubercle

  2. elongated rough dorsal surface

  3. large lateral surface

  4. concave medial surface

  5. large dorsolateral sellar surface (i.e. saddle-shaped) 3 which projects distally between the thumb and index metacarpals, and also has a small distomedial facet articulating with the index metacarpal base

  6. small concave proximal surface

  • articulates with the scaphoid at the midcarpal joint

  • articulates with the trapezoid at its intercarpal joint

  • articulates with the thumb metacarpal at the carpometacarpal joint of the thumb

  • two layers of the flexor retinaculum attach either side of the groove of the trapezium

  • radial collateral ligament attaches to the lateral surface

  • capsule of the carpometacarpal joint of the thumb attaches to the lateral surface

The tendon of flexor carpi radialis runs through the groove and the radial artery is directly related to the dorsal surface.

Supplied by distal branches of the radial artery, primarily via the dorsal surface 2.

Drained by tributaries of the radial vein.

Females have a significantly smaller sellar surface, with a fundamentally different shape of that surface 1.

The trapezium may be visualized on a number of series of the distal upper limb including:

CT or MRI imaging will demonstrate the trapezium and should be considered if there is clinical suspicion of occult injury. 

The trapezium begins to ossify in the 4th to 5th year.

Trapezium derives from the ancient Greek word "trapezion", which means "small table". It later came to mean a four-sided figure with no parallel sides.

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