Triquetrum fracture

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Background

  • 3rd most common carpal bone injury (following scaphoid and lunate fractures)[1]

Mechanism of injury

  • Avulsion Fracture: Twisting motion of hand 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

Avulsion fracture of triquetrum
  • Lateral/oblique in partial pronation
    • Best for seeing avulsion fracture (tiny flake of bone on dorsum of triquetrum)
  • PA
    • Best for seeing nondisplaced fracture

Management

Avulsion fracture

Body fracture

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

Disposition

  • Outpatient

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.