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Case Reports
. 2015 Jul-Sep;5(3):29-31.
doi: 10.13107/jocr.2250-0685.300.

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

Ranajit Panigrahi  1 , Manas Ranjan Biswal  1 , Nishit Palo  1 , Naresh Panigrahi  1
Affiliations
Case Reports

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

Ranajit Panigrahi et al. J Orthop Case Rep. 2015 Jul-Sep.

Abstract

Introduction: 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.

Case report: 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.

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

Keywords: CT; Coronal; Fractures; Trapezium; Trauma; X-Ray.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Clinical Photographs on presentation.
Figure 2
Figure 2
Clinical Photographs on presentation.
Figure 3
Figure 3
Anteroposterior view of the wrist showing the undisplaced incomplete coronal fracture of the trapezium.
Figure 4
Figure 4
Lateral radiograph of the wrist showing intact 1st CMC Joint with major dorsal fragment and smaller volar fragment.
Figure 5
Figure 5
CT scan showing a major dorsal fragment (red arrow) and smaller volar fragment white arrow.
Figure 6
Figure 6
Follow up at 6 months- Maximum thumb abduction.
Figure 7
Figure 7
Follow up at 6 months-Full range of palmar flexion.
Figure 8
Figure 8
Follow up at 6 months-. Full range of dorsiflexion.
Figure 9
Figure 9
Follow up x-rays (anteroposterior) at 6 months showing united fracture with congruent joints.
Figure 10
Figure 10
Follow up x-rays (oblique) at 6 months showing healed fracture with congruent joints.
See this image and copyright information in PMC

References

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