The Common Vein Copyright 2011
Definition
Fractures of the trapezium are usually caused by n axial load of an adducted thumb.
Trapezium fractures are either ridge avulsion fractures or vertical body fractures. Ridge avulsion fractures are due to avulsion of the flexor retinaculum
The fracture may be complicated in the acute phase by neurovascular injury, or in the subacute or chronic phases by nonunion, malunion, infection, osteonecrosis, or osteoarthritis.
The diagnosis of this injury is usually made by a combination of physical examination and x-ray imaging.
Imaging includes the use of plain x-rays, and if indicated CT-scan, or MRI.
Nondisplaced fractures are treated with thumb spica splinting or casting for 6 weeks. ORIF is performed if there is articular involvement of the carpometacarpal joint, a comminuted fracture, or displaced fracture. Severely comminuted fractures may require bone grafting at a later time.
The Normal Trapezium |
| Courtesy Ashley Davidoff MD 45738c01 |
References
Davis MF, Davis PF, Ross DS. Expert Guide to Sports Medicine. ACP Series, 2005.
Elstrom J, Virkus W, Pankovich (eds), Handbook of Fractures (3rd edition), McGraw Hill, New York, NY, 2006.
Koval K, Zuckerman J (eds), Handbook of Fractures (3rd edition), Lippincott Williams & Wilkins, Philadelphia, PA, 2006.
Lieberman J (ed), AAOS Comprehensive Orthopaedic Review, American Academy of Orthopaedic Surgeons, 2008.
Moore K, Dalley A (eds), Clinically Oriented Anatomy (5th edition), Lippincott Williams & Wilkins, Philadelphia, PA, 2006.