Gregory Waryasz MD, Ashley Davidoff MD
The Common Vein Copyright 2011
Definition
Fractures of the triquetrum are usually caused by ligament avulsion. These injuries are the 3rd most common carpal bone fracture. Forced ulnar deviation and dorsiflexion can create a shearing mechanism due to impingement by the ulnar styloid.
These injuries are the 3rd most common carpal bone fracture. Forced ulnar deviation and dorsiflexion can create a shearing mechanism due to impingement by the ulnar styloid.
The common fractures include a shear or chisel fracture from impingement of the ulnar styloid, a body fracture, or an avulsion fracture.
Volar intercalated segment instability (VISI) can result from untreated avulsion fractures.
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 a short or long arm cast or ulnar gutter splint for 6 weeks. Displaced fractures are treated with surgical repair. Shear injuries may require an excision of the fracture fragment if there is pain.
The Normal Triquetrum
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| 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.
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