Triquetrum fracture

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

AP view

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

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. 
  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.
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