TRAPEZOID FRACTURE

TRAPEZOID FRACTURE
These are very uncommon fractures. Dislocations
are more common than isolated fractures.
Mechanism of Injury
• Direct blow
• Axial loading injury to the index metacarpal.
Clinical Features
Pain, swelling, tenderness over the wrist and painful
resisted flexion are the usual complaints.
Investigations
Plain X-rays of the wrist are not reliable. CT scan is
a better option.
Treatment
• Undisplaced fractures are treated by below elbow
cast for 4 to 6 weeks.
• In displaced fractures (> 1 mm or diastases
> 2 mm) open reduction and rigid internal
fixation is advised.
TRAPEZIUM FRACTURE
This accounts for 1 to 5 percent of wrist fractures. It
could be isolated fracture or dislocations.
Mechanism of Injury
• Fall on an outstretched hand.
• Direct blow over the dorsum of the hand.
Classifications
Trapezium fractures are divided into:
• Body fractures
• Ridge fractures (Palmar)
– Type I: Fracture base of the trapezoid ridge.
– Type II: Fracture of the tip of the trapezial ridge.
• Dislocations: This could be dorsal, palmar or radial
and may be associated with fracture of the
scaphoid and trapezium
These are very uncommon fractures. Dislocations
are more common than isolated fractures.
Mechanism of Injury
• Direct blow
• Axial loading injury to the index metacarpal.
Clinical Features
Pain, swelling, tenderness over the wrist and painful
resisted flexion are the usual complaints.
Investigations
Plain X-rays of the wrist are not reliable. CT scan is
a better option.
Treatment
• Undisplaced fractures are treated by below elbow
cast for 4 to 6 weeks.
• In displaced fractures (> 1 mm or diastases
> 2 mm) open reduction and rigid internal
fixation is advised.
TRAPEZIUM FRACTURE
This accounts for 1 to 5 percent of wrist fractures. It
could be isolated fracture or dislocations.
Mechanism of Injury
• Fall on an outstretched hand.
• Direct blow over the dorsum of the hand.
Classifications
Trapezium fractures are divided into:
• Body fractures
• Ridge fractures (Palmar)
– Type I: Fracture base of the trapezoid ridge.
– Type II: Fracture of the tip of the trapezial ridge.
• Dislocations: This could be dorsal, palmar or radial
and may be associated with fracture of the
scaphoid and trapezium