Trapezium fracture: a common clinical mimic of scaphoid fracture
Fractures of the trapezium are rarely diagnosed on plain radiographs after acute wrist trauma. High-resolution cross-sectional imaging identifies fractures of the trapezium as the most common radiographically occult carpal bone fracture. We review the fracture frequency, mechanisms and patterns of trapezium fractures.
Cone beam CT was performed in patients with suspected radiographically occult radiocarpal fracture following acute injury. The frequency of carpal bone fractures was assessed and compared.
Ninety-three radiographically occult wrist fractures were identified in 166 patients with acute trauma and negative radiographs. The trapezium was the most frequently fractured carpal bone, making up 20.4% of wrist fractures. Seventy-nine percent of trapezium fractures involved the volar ridge. The scaphoid was the clinically suspected fractured bone at initial assessment in 84% of patients with trapezium fractures.
Fractures of the trapezium in acute wrist trauma are much more common than described in the literature. If initial radiographs are negative, a fracture of the trapezium is more likely to be present than one of the scaphoid, despite high levels of clinical suspicion for scaphoid injuries. Awareness of the types and mechanisms of trapezium fracture is important. Cross-sectional imaging should be considered in all cases of post-traumatic wrist pain with negative radiographs.
KeywordsTrapezium Fracture Trauma Cone beam CT
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This research study received approval by our institution’s ethical review board.
Informed consent was obtained from all individual participants included in the study.
- 1.Cooney WP (2011) The wrist: diagnosis and operative treatment. Lippincott Williams & Wilkins, Philadelphia, PA 2011/12/21. 2300 pGoogle Scholar
- 3.Gaebler (2006) Fractures and dislocations of the carpus. In: Bucholz RWHJ, Court-Brown C (eds) Rockwood and Green’s fractures in adults, 6th edn. Lippincott Williams & Wilkins, Philadelphia, PA, pp 857–908Google Scholar
- 4.Suthersan MCS (2010) Isolated comminuted fracture of the trapezium: a case report and review of the literature. Internet J Orthopedic Surg 18(Number 2)Google Scholar
- 29.Botchu R, Bianchi S Sonography of trapezial ridge fractures. Electronic, pp 1097–0096Google Scholar
- 31.Drake R, Wayne Vogl A, Mitchell AWM (2014) Gray’s anatomy for students E-book. Elsevier Health Sciences 2014/1/30. 1192 pGoogle Scholar
- 41.Browner BD, Levine AM, Jupiter JB, Trafton PG, Krettek C (2008) Skeletal trauma: 2-volume set. Elsevier Health Sciences 2008/12/22. 2784 pGoogle Scholar
- 44.Botte MJ, von Schroeder HP, Gellman H, Cohen MS (1992) Fracture of the trapezial ridge. Clin Orthop Relat Res 276:202–205Google Scholar