Trapezium Fractures: The Hidden Wrist Injury You Might Be Missing

Published: Apr 02, 2024

Trapezium fractures are often overlooked wrist injuries that can have serious consequences if left untreated. Understanding the signs and proper diagnosis is crucial for preventing long-term complications.

Spotting the Signs: How to Recognize a Trapezium Fracture

Patients with trapezium fractures typically experience focal tenderness over the trapezium bone at the base of the thumb. Pain and weakness when pinching or making an 'OK' sign are common. Swelling may be minimal, but ecchymosis (bruising) can occur. Snuffbox tenderness may also be present, similar to a scaphoid fracture.

Diagnosis: Why X-rays Aren't Enough

Standard wrist X-rays often miss trapezium fractures due to overlapping shadows from other bones. Special views like the Bett view or carpal tunnel view can help, but CT or MRI scans are often necessary for a definitive diagnosis. Cone beam CT is a promising new option that provides high-resolution images with less radiation exposure.

$A trapezium fracture is a wrist injury involving a break in the trapezium bone at the base of the thumb, often missed in standard X-rays and requiring advanced imaging for accurate diagnosis.$

Treatment: When to Splint and When to Refer

Nondisplaced trapezium fractures can often be treated with 4-6 weeks of immobilization in a thumb spica cast. However, fractures that are displaced more than 2mm, comminuted, or associated with other injuries should be referred to a hand surgeon. Proper follow-up is crucial to ensure healing and prevent complications.

Frequently Asked Questions

How common are trapezium fractures? +

They represent about 4% of all carpal fractures.

Can you still move your thumb with a trapezium fracture? +

Yes, but it will likely be painful and weak.

How long does it take to recover from a trapezium fracture? +

Typically 4-6 weeks of immobilization, followed by rehabilitation.

Are trapezium fractures often missed? +

Yes, they can be difficult to see on standard X-rays.

Key Takeaways

Trapezium fractures require a high index of suspicion and often advanced imaging for proper diagnosis and treatment.

If you suspect a wrist injury, don't hesitate to discuss your symptoms with Doctronic for personalized guidance and potential referral options.

References

van Onselen EB, Karim RB, Hage JJ, Ritt MJ. Prevalence and distribution of hand fractures. J Hand Surg Br 2003; 28:491.

Gibney B, Smith M, Moughty A, et al. Incorporating Cone-Beam CT Into the Diagnostic Algorithm for Suspected Radiocarpal Fractures: A New Standard of Care? AJR Am J Roentgenol 2019; 213:1117.

Always discuss health information with your healthcare provider.