Triquetrum fracture

Background

• 2nd most common carpal bone injury
• 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

Differential Diagnosis

Carpal fractures

AP view

• Scaphoid fracture
• Lunate fracture
• Triquetrum fracture
• Pisiform fracture
• Trapezium fracture
• Trapezoid fracture
• Capitate fracture
• Hamate fracture

Diagnosis

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
  • Wrist splint (Forearm volar splint) x1-2wks
• Body fracture
  • Refer to orthopedist
    • Stable: cast x 6wks
    • Unstable (>1mm displacement): May require internal fixation

See Also

• Carpal fractures