Trapezium fracture

Background

  • Occurs via direct blow to thumb or dorsiflexion and radial deviation force
  • Major complication is nonunion

Clinical Features

  • Painful thumb movement
  • Weak pinch
  • TTP at apex of anatomic snuffbox, base of thenar eminence

Differential Diagnosis

Carpal fractures

AP view

Evaluation

  • Hand x-ray (best seen on 20-degree pronated oblique view)
Trapezium fracture

Management

General Fracture Management

Immobilization

Disposition

  • Discharge with close hand/ortho follow up

Specialty Care

  • Displaced fracture >1mm or diastasis >2mm require surgery

See Also

References