Triquetrum fracture

From WikEM
Jump to: navigation, search

Background

  • 3rd most common carpal bone injury (following scaphoid and lunate fractures)[1]
  • Mechanism of injury
    • Avulsion fracture: Twisting motion of hand that is suddenly resisted
    • Body fracture: Direct trauma (commonly accompanied by lunate/perilunate dislocations)

Clinical Features

  • Localized tenderness over dorsum of wrist in area immediately distal to ulnar styloid
  • Evaluate for deep branch of ulnar nerve impairment[1]

Differential Diagnosis

Carpal fractures

Evaluation

  • Hand x-ray
    • PA - best for seeing nondisplaced fracture
    • Lateral/oblique in partial pronation - best for seeing avulsion fracture (tiny flake of bone on dorsum of triquetrum)
Avulsion fracture of triquetrum

Management

Avulsion fracture

Body fracture

  • Stable: cast x 6wks
  • Unstable (>1mm displacement): May require internal fixation

Disposition

  • Discharge with orthopedic surgery follow-up

See Also

References

  1. 1.0 1.1 German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.