January 21, 2012

Triquetral Fracture

A lateral wrist radiograph shows a small bone fragment (arrow) dorsum to the wrist with overlying soft tissue swelling.

Facts:
  • Second most common carpal bone fracture
  • Two main types: dorsal chip fracture and body fracture
  • Dorsal chip fracture (like in our case ) believed to be due to forceful impingement of the triquetrum during wrist hyperextension
  • Body fracture frequently associated with perilunate dislocation (direct blow)
  • Pain and swelling localized at the dorsum of the wrist where triquetrum is located
  • Complication: motor branch of ulnar nerve injury
Imaging
  • Chip fracture best seen on lateral radiograph with hand in flexion
  • Body fracture best seen on AP and oblique radiographs
  • Fractures are possibly underreported. CT can help in suspected cases.
Reference:
Simon RR, Koenigsknecht SJ. Emergency orthopedics: the extremities, 2001.

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