Trapezoid fracture

Last revised by Daniel J Bell on 21 Apr 2022

Trapezoid fractures are the least common carpal fracture. They typically occur as the result of an axial force through the second metacarpal. 

Epidemiology

They account for ~0.4% of all carpal fractures 1.

Radiographic features

The trapezoid is in a relatively immobile, and protected location hence the rarity of an isolated fracture. Given the wedged shape and weaker dorsal ligamentous support, fractures will dislocate in the dorsal direction 2. It is often associated with a second metacarpal fracture.

Treatment and prognosis

Treatment varies from conservative management to open reduction internal fixation, failure to recognize can lead to functional problems such as decreased grasp power 2.

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