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The Uncommon Trapezium Fracture: A Case Series
S R Beekhuizen1, C R Quispel1, J Jasper1
1Department of Orthopaedic Surgery, HagaZiekenhuis, The Hague, The Netherlands.
Journal of Wrist Surgery
|February 7, 2020
Summary
Isolated trapezium fractures are rare but can cause significant pain. Conservative treatment with navicular cast immobilization for 4-6 weeks yielded good results in four cases, avoiding surgery.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Radiology
Background:
- Isolated trapezium fractures are uncommon, representing 1-5% of carpal fractures.
- These fractures are often missed on standard radiographs due to their subtle nature.
- Damage to the trapezium's articular surfaces can lead to pain and restricted movement.
Observation:
- Four cases of isolated trapezium fractures were reviewed.
- All presented cases were treated conservatively.
- No surgical intervention was required for any of the cases.
Findings:
- Conservative management, specifically navicular cast immobilization for 4-6 weeks, resulted in good outcomes.
- Surgical fixation is indicated only for irreducible displaced fractures or significant articular step-off.
Implications:
- Early diagnosis and treatment of trapezium fractures are crucial for preserving articular congruence.
- Conservative treatment may be sufficient for many isolated trapezium fractures, potentially avoiding surgical risks.
- Navicular cast immobilization is a recommended initial treatment strategy for these fractures.
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