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Isolated Trapezium Fracture: A Rare and Challenging Diagnosis
Jheniffer Rodrigues Cação1, Márcio Luís Duarte2,3
1Department of Radiology, Universidade de Ribeirão Preto - Campus Guarujá, Guarujá (SP), Brazil.
Abstract:
Isolated trapezium fractures are a rare type of injury, accounting for approximately 4% of all carpal fractures. Due to their nonspecific symptoms and difficulty in detection with conventional radiography, these fractures are often underdiagnosed. This case report details a 22-year-old male who sustained a trapezium fracture after a motorcycle accident. The patient presented with wrist pain and mild edema, but radiographs were normal. However, computed tomography (CT) revealed a small fracture in the dorsal portion of the trapezium. Conservative treatment with wrist immobilization was administered, resulting in full recovery. The article discusses the rarity of trapezium fractures, their mechanisms of injury, diagnostic challenges, and treatment options. The use of imaging techniques such as CT and magnetic resonance imaging plays a crucial role in diagnosis, as they can detect fractures that may not be visible on plain X-rays. Early detection and treatment are essential to prevent complications such as arthritis, nonunion, and loss of thumb function. While there is no consensus on the optimal treatment approach, conservative management with immobilization or surgical interventions such as open reduction and internal fixation or closed reduction with pin placement are commonly used.
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