Trapezium fracture: Difference between revisions
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*Weak pinch | *Weak pinch | ||
*TTP at apex of anatomic snuffbox, base of thenar eminence | *TTP at apex of anatomic snuffbox, base of thenar eminence | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Carpal fractures}} | {{Carpal fractures}} | ||
==Evaluation== | |||
*Hand x-ray (best seen on 20-degree pronated oblique view) | |||
[[File:Trapezium_Fracture.jpg|thumb|Trapezium fracture]] | |||
==Management== | ==Management== | ||
{{General Fracture Management}} | |||
===Immobilization=== | |||
*Short arm [[thumb spica splint]] | *Short arm [[thumb spica splint]] | ||
*Displaced | |||
==Disposition== | |||
*Discharge with close hand/ortho follow up | |||
===Specialty Care=== | |||
*Displaced fracture >1mm or diastasis >2mm require surgery | |||
==See Also== | ==See Also== | ||
*[[Carpal fractures]] | *[[Carpal fractures]] | ||
== | ==References== | ||
<references/> | |||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
Latest revision as of 04:48, 18 September 2019
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
- Scaphoid fracture
- Lunate fracture
- Triquetrum fracture
- Pisiform fracture
- Trapezium fracture
- Trapezoid fracture
- Capitate fracture
- Hamate fracture
Evaluation
- Hand x-ray (best seen on 20-degree pronated oblique view)
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Immobilization
- Short arm thumb spica splint
Disposition
- Discharge with close hand/ortho follow up
Specialty Care
- Displaced fracture >1mm or diastasis >2mm require surgery