Triquetral fracture-pooping duck sign

Case contributed by Dr Irvine Sihlahla

Presentation

Fall on an outstretched hand, painful left hand for 3 days

Patient Data

Age: 40 years
Gender: Female

Hand

x_ray

The case illustrates a subtle fleck of avulsed bone posterior to the triquetrum giving the classical pooping duck sign of dorsal cortical triquetral fracture. The fracture is difficult to visualize on anteroposterior and oblique views. No other carpal bone fracture or dislocation was noted.

Zoomed view

x_ray

A zoomed view shows a fleck of avulsed bone posterior to the triquetrum consistent with the dorsal triquetral avulsion fracture.

Case Discussion

The case illustrates the classical pooping duck sign of dorsal cortical triquetral fracture. The triquetrum is the second most fractured carpal bone. Differentials would include accessory os triquetrum or os tringulare.

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