Isolated Coronal Fracture of Trapezium- A Case Report with Review of Literature

Isolated trapezium fractures accounts for 3-5% of all carpal fractures, are often missed on initial presentation. Trapezial fractures should be treated early given its importance in grip and pinch. We report a rare isolated coronal fracture of trapezium, following fall on an outstretched hand.

A 40-year-old right lady presented with pain in right hand due to fall on out stretched hand. The radial half of wrist and lower forearm were swollen. Tenderness over trapezium and 1st metacarpal base with terminal thumb movements restricted. X-Ray revealed undisplaced incomplete coronal fracture of the trapezium. CT scan confirmed coronal split fracture of the trapezium with a major volar fragment and a dorsal fragment without articular involvement. The patient refused operative intervention. Fracture was treated conservatively. The follow-up radiographs showed normal articular relationship of the trapezium with the base of first metacarpal and scaphoid. The fracture healed with no complications.

Carpal fracture diagnosis requires high clinical suspicion. X-Rays and CT scans define pattern orientation and understanding.