Difference between revisions of "Triquetrum fracture"

(Background)
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==Background==
 
==Background==
 
*3rd most common carpal bone injury (following scaphoid and lunate fractures)<ref name="Hand and wrist emergencies">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.</ref>
 
*3rd most common carpal bone injury (following scaphoid and lunate fractures)<ref name="Hand and wrist emergencies">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.</ref>
 
+
*Mechanism of injury
===Mechanism of injury===
+
**Avulsion fracture: Twisting motion of hand that is suddenly resisted
*Avulsion Fracture: Twisting motion of hand is suddenly resisted
+
**Body fracture: Direct trauma (commonly accompanied by lunate/perilunate dislocations)
*Body Fracture: Direct trauma (commonly accompanied by lunate/perilunate dislocations)
 
  
 
==Clinical Features==
 
==Clinical Features==
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==Evaluation==
 
==Evaluation==
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*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)
 +
 
[[File:Triquetrum_Fracture.jpg|thumb|Avulsion fracture of triquetrum]]
 
[[File:Triquetrum_Fracture.jpg|thumb|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==
 
==Management==
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===Body fracture===
 
===Body fracture===
*Refer to orthopedist
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*Stable: cast x 6wks
**Stable: cast x 6wks
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*Unstable (>1mm displacement): May require internal fixation
**Unstable (>1mm displacement): May require internal fixation
 
  
 
==Disposition==
 
==Disposition==
*Outpatient
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*Discharge with orthopedic surgery follow-up
  
 
==See Also==
 
==See Also==

Revision as of 21:03, 4 July 2017

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

AP view

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.