Triquetrum fracture
Revision as of 11:54, 16 October 2016 by Rossdonaldson1 (talk | contribs)
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
Differential Diagnosis
Carpal fractures
- Scaphoid fracture
- Lunate fracture
- Triquetrum fracture
- Pisiform fracture
- Trapezium fracture
- Trapezoid fracture
- Capitate fracture
- Hamate fracture
Evaluation
- 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
- Wrist splint (Forearm volar splint) x1-2wks
- Body fracture
- Refer to orthopedist
- Stable: cast x 6wks
- Unstable (>1mm displacement): May require internal fixation
- Refer to orthopedist
See Also
References
- 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.
- ↑ 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.