Kim BS, Grieb G, Rhodius P, Böcker AH, Stromps JP, Krämer NA, Pallua N. Clin Pract. 1 Among the carpal bones, the trapezoid bone is the least likely to be fractured, owing to its stability provided by strong ligamentous attachments. Illustration and x-ray showing a break in the mid-portion, or "waist," of the scaphoid. Fractures of the trapezium are often associated with other fractures, mainly of the thumb metacarpal and the distal radius. Nagumo, Akira MD; Toh, Satoshi MD; Tsubo, Kenji MD; Ishibashi, Yasuyuki MD; Sasaki, Tomoyuki MD In this type of fracture, the bone fragments line up correctly. The authors report two cases of isolated, undisplaced, fractures of the trapezoid bone. Treatment varies from conservative management to open reduction internal fixation, failure to recognize can lead to functional problems such as decreased grasp power 2. It is also connected by very strong ligaments to the trapezium, capitate and, scaphoid. We presented a rare case of a trapezoid fracture associated with a scaphoid fracture caused by punching a ball in a football goalkeeper. Scaphoid fractures are generally classified as either displaced or nondisplaced. Most trapezoid fractures were diagnosed on computed tomographic scan. Epub 2020 Feb 4. Background: The trapezoid is the least commonly fractured carpal bone, comprising 4% of all carpal fractures. dorsal intercalated segment instability (DISI), volar intercalated segment instability (VISI), scaphoid nonunion advanced collapse (SNAC), triangular fibrocartilaginous complex (TFCC) injuries, ulnar-sided wrist impaction and impingement syndromes, calcium pyrophosphate dihydrate deposition disease. The shape and size of this bone and its location below the thumb cause the integrity of the trapezium to deteriorate over time. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. The injury in our patient may have been a stress fracture or a nonunion of an initial dorsal intra-articular fracture. 2020 Apr;39(2):353-371. doi: 10.1016/j.csm.2019.12.006. Carpal fracture (1) is a medical condition where a carpal bone gets fractured. Carpal bone fractures involve the eight bones that form the wrist. Trapezoid fractures are an uncommon carpal fracture. Fractures to bones of the distal carpal row—comprising the trapezium, trapezoid, capitate, and hamate— are less frequent than fractures of bones in the proximal row (scaphoid, lunate, triquetrum, and pisiform). Unable to process the form. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. The trapezoid bone (also known as the os trapezoideum or the lesser multangular) is the smallest carpal bone in the distal row, sitting lateral to the capitate. 2. NLM Would you like email updates of new search results? eCollection 2019. Background: The trapezoid is the least commonly fractured carpal bone, comprising 4% of all carpal fractures. Afifi N, Lu JJ. Most trapezoid fractures were diagnosed on computed tomographic scan. An open fracture; A fracture in which the bone pieces move before they heal; Loose bone fragments that could enter a joint; Damage to the surrounding ligaments, nerves or blood vessels; Fractures that extend into a joint; Even after reduction and immobilization with a cast or splint, your bones can shift. Fractures of the carpal bones involve only a single bone or complex bones with or without ligament rupture. (2011) The western journal of emergency medicine. Axial force, while applied to the second metacarpal base, can cause the trapezoid bone structure to become injured or even to fracture. The trapezium bone is a small oblong bone which plays a role in the stability of the carpal tunnelas well as the stability of the thumb joint. Rita M. Sadowski, Richard D. Montilla. Nagumo, Akira MD; Toh, Satoshi MD; Tsubo, Kenji MD; Ishibashi, Yasuyuki MD; Sasaki, Tomoyuki MD The next common is a Triquetrum fracture. Trapezium Bone Anatomy and Structure Surfaces and Articulation. This fracture often is as a result of trauma due to falling on the wrist directly or on outstretched hands. Trapezium Bone Anatomy and Structure Surfaces and Articulation. Triquetrum fractures are the second least common fractures among carpal bones. To date, few articles have been published on isolated trapezoid fractures. The authors present a single bone fracture of the trapezoid in a 40-year-old man. BACKGROUND Trapezoid fractures are very uncommon, accounting for less than 1% of all wrist fractures. However, fractures of the trapezoid are rarely seen. Disease Ontology - OBO (Open Biomedical Ontologies) Closed fracture of carpal bone, unspecified; Fracture of carpal bone(s) However, we are aware of no previous reports of occult fracture of the trapezoid bone, such as was described in this paper. Given the wedged shape and weaker dorsal ligamentous support, fractures will dislocate in the dorsal direction 2. It is often associated with a second metacarpal fracture. The injury is usually the result of high-velocity force pushing the index metacarpal into the trapezoid, causing either a fracture or a fracture-dislocation of the trapezoid. The trapezium articulates with two of the carpal bones, the scaphoid, and the trapezoid as well as with the first metacarpal bone [7].. Isolated fractures of this bone are even more rare, with just a few reports in the literature. On the other hand, trapezoid bone fracture is rare. Nondisplaced fracture of trapezoid [smaller multangular], unspecified wrist, initial encounter for closed fracture. Trapezoid Fracture Associated with Scaphoid Fracture in a Football Goalkeeper. Trapezium fractures are uncommon carpal bone injuries. A fracture in the trapezium bone is usually due to a fall with an outstretched hand or an injury to the wrist. {"url":"/signup-modal-props.json?lang=us\u0026email="}. Nammour M, Desai B, Warren M, Godshaw B, Suri M. Ochsner J. A nondisplaced scaphoid fracture means that the bone has not shifted at all out of position, and the fracture may not even be visible on an x-ray image. The carpal bones are 8 small bones which make up the wrist. Isolated fractures are rarely seen and usually related to the high energy trauma. The mechanism for development of fracture of the trapezoid alone is unknown. Trapezoid fractures occur when the second metacarpal butts up against it. A fracture of the carpal trapezoid bone ; Anatomy. extra-articular vs. intra-articular) fracture pattern (e.g. simple vs. comminuted) integrity of the coracoclavicular ligments conoid (medial) and trapezoid (lateral) provide primary resistance to superior displacement of the lateral clavicle The next common is a Triquetrum fracture. To our knowledge and based on a literature review, this is the first report of a true isolated trapezoid fracture without accompanying dislocation and without associated metacarpal, carpal, or distal radial fractures. An Occult Fracture of the Trapezoid Bone A Case Report.  |  Being surrounded by the trapezium, capitate, scaphoid, and the second metacarpal, it is often sheltered from minor blows and injuries. Clin Sports Med. Isolated fractures of this bone are even more rare, with just a few reports in the literature. Fractures of the lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and hamate bones are the focus of this article. Results: We treated 11 patients for trapezoid fractures over the 10-year period. BACKGROUND:Trapezoid fractures are very uncommon, accounting for less than 1% of all wrist fractures. However, fracture of the trapezoid seemed to occur when the wrist joint was forced with excessive flexion stress that was placed on the trapezoid through the second metacarpal bone indirectly. A trapezoid fracture is a break in the trapezoid bone of the wrist. Am J Case Rep. 2019 Jun 5;20:790-793. doi: 10.12659/AJCR.915757. In this type of fracture, the bone fragments have moved out of their normal position. Fracture of the trapezoid bone: A case report ☆. When the trapezoid is fractured, the mechanism is usually a high-energy axial blow to the second metacarpal. The trapezoid is only 0.2% of all carpal fractures. A fracture of the carpal trapezoid bone ; Anatomy. HHS What causes a Wrist Fracture? Trapezoid fractures usually occur in association with other injuries, most commonly … It has been reported that less than half of cases were improperly diagnosed at initial hospital visit, with the trape-zoid fracture in one patient having been identified only after 99 days [10]. We reviewed case notes regarding mechanism of injury, fracture pattern, mode of diagnosis, and time to diagnosis and treatment. The protected position of the trapezoid between the base of the second metacarpal, capitate, trapezium, and scaphoid and the strong ligamentous attachments provide much stability, limiting the likelihood of an isolated fracture. A common clinical problem encountered with scaphoid fractures is delayed diagnosis. A rare isolated trapezoid fracture. The trapezoid resides in the distal row of carpal bones, has a keystone shape, and has tight local ligamentous connections 1; Articulates with the trapezium radially, the capitate ulnarly, the scaphoid proximally, and the second metacarpal distally ; Common symptoms reported by people with trapezium fracture Isolated fractures of this bone are even more rare, with just a few reports in the literature. A correct diagnosis was made in 5 cases on initial evaluation. They typically occur as the result of axial force through the second metacarpal. trapezoid fracture on plain radiographs is generally difficult, as the trapezoid is small and overlaps with other carpal bones. Because of its well-protected position in the wrist, traumatic lesions of the trapezoid bone are rare. Scaphoid fracture as a "puncher's fracture". The trapezoid is the least commonly fractured carpal bone. The incidence of trapezoid fractures is exceedingly rare, occurring in less than 1% of carpal fractures. CASE REPORT A … The commonest mechanism of injury is a shearing force applied to the first web space by an object held in the hand, for example the … Trapezoid bone fracture is the least common fracture owing to the fact that it is strictly bounded to scaphoid, capitate and the base of the second metacarpal. 814.06 is a legacy non-billable code used to specify a medical diagnosis of closed fracture of trapezoid bone [smaller multangular] of wrist. A 19-year-old male who played as a football goalkeeper visited our hospital with complaints of sustained pain from the right wrist to the hand after punching a ball. We reviewed case notes regarding mechanism of injury, fracture pattern, mode of diagnosis, and time to diagnosis and treatment. 12 (4): 523-4. In this report, we describe a rare case of isolated trapezoid fracture encountered clinically. A correct diagnosis was made in 5 cases on initial evaluation. A trapezium fracture requires a direct blow to the wrist when the thumb is adducted. fracture displacement corresponds to fracture location (e.g. Isolated trapezoid fracture: four cases of a rare fracture on MRI. The diagnosis of this injury is usually made by a combination of physical examination and x-ray imaging. The trapezoid bone (lesser multangular bone) is a carpal bone in tetrapods, including humans.It is the smallest bone in the distal row of carpal bones that give structure to the palm of the hand. Trapezoid bone fracture is the least common fracture owing to the fact that it is strictly bounded to scaphoid, capitate and the base of the second metacarpal. The trapezium is on the radial side of the distal carpal row, and articulates distally with the thumb metacarpal and proximally with the scaphoid and trapezoid (image 1 and figure 1 and figure 2 and figure 3). Carpal Bone Fractures. They can either occur in isolation or combination with another carpal bony injury. fracture or dislocation. The trapezium and trapezoid are collectively known as the multangulars. Compound Dorsal Dislocation of Lunate with Trapezoid Fracture. They typically occur as the result of axial force through the second metacarpal. Trapezoid fractures are commonly associated with other carpal fractures (, Fig 11,) and may occur with dorsal displacement of the trapezoid (, 14). The following list attempts to classify Closed fracture of trapezoid bone [smaller multangular] of wrist into categories where each line is subset of the next. Trapezoid fractures occur when a strong bending or axial force is applied to the second metacarpal base. The mechanism of trapezoid injury is thought to be axial disruption 9 , 10 . Anatomically, the trapezoid is keystone in shape with a dorsal surface width twice that of its palmar surface. Displaced fracture. Because the trapezoid is fastened to the trapezium, capitate, and scaphoid by strong ligaments, fracture or dislocation is limited by this rigid fixation. Introduction . The trapezoid bone has a very stable position within the wrist, forming a relatively immobile joint with the second metacarpal base distally. BACKGROUND:Trapezoid fractures are very uncommon, accounting for less than 1% of all wrist fractures. This site needs JavaScript to work properly. Rare Isolated Trapezoid Fracture: A Case Report:. The trapezoid bone has a very stable position within the wrist, forming a relatively immobile joint with the second metacarpal base distally. 2. This code was replaced … Common symptom. 2016 Dec 13;6(4):879. doi: 10.4081/cp.2016.879. Displaced fracture. They account for ~0.4% of all carpal fractures 1. 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. A tomogram of the carpal bone was useful in diagnosing the trapezoid fracture. The trapezium articulates with two of the carpal bones, the scaphoid, and the trapezoid as well as with the first metacarpal bone [7].. Any of the carpal bones can break, causing a broken wrist. Fractures can also occur at both the proximal and distal ends of the bone. However, fractures of the trapezoid are rarely seen. eCollection 2016 Oct 24. The authors present a single bone fracture of the trapezoid in a 40-year-old man. On the other hand, trapezoid bone fracture is rare. This occurred in the same manner that a walnut is broken with nutcrackers.  |  In this report, we describe a rare case of isolated trapezoid They are the Scaphoid, Hamate, Lunate, Trapezium, Trapezoid, Capitate and Pisiform. Approach to Isolated Trapezoid Fractures. Isolated fractures of the trapezoid bone have been rarely reported in the literature, the mechanism of injury being an axial or bending load transmitted through the second metacarpal. Yamamoto T, Matsushita T, Ito K, Matsushima S, Yoshida K, Kuroda R. Case Rep Orthop. What people are taking for it. Any of the carpal bones can break, causing a broken wrist. Dislocation of the trapezoid has been reported in 30 patients; fractures are seen even less frequently and us … When it does it is the result of a fall on an outstretched, dorsiflexed hand. The trapezoid is the most rarely fractured carpal bone. The trapezoid bone (lesser multangular bone) is a carpal bone in tetrapods, including humans.It is the smallest bone in the distal row of carpal bones that give structure to the palm of the hand. The pisiform, a sesamoid bone nestled in the flexor carpi ulnaris tendon, rarely fractures. Because the trapezoid is fastened to the trapezium, capitate, and scaphoid by strong ligaments, fracture or dislocation is limited by this rigid fixation. There may be gaps between the pieces of bone or fragments may overlap each other. Check for errors and try again. ICD-9-CM 814.06 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 814.06 should only be used for claims with a date of service on or before September 30, 2015. However, fracture of the trapezoid seemed to occur when the wrist joint was forced with excessive flexion stress that was placed on the trapezoid through the second metacarpal bone indirectly. Trapezoid fractures are an uncommon carpal fracture. A fracture in the trapezium bone is usually due to a fall with an outstretched hand or an injury to the wrist. Introduction. To date, few articles have been published on isolated trapezoid fractures. Disease Ontology - OBO (Open Biomedical Ontologies) Closed fracture of carpal bone, unspecified; Fracture of carpal bone(s) Because the trapezoid is fastened to the trapezium, capitate, and scaphoid by strong ligaments, fracture or dislocation is limited by this rigid fixation. A Scaphoid fracture is the most common wrist fracture. The trapezium is involved in many small motions over time due to how frequently most individuals use their thumbs.  |  Carpal Fractures Other than Scaphoid in the Athlete. We describe a case of an isolated trapezoid fracture that was managed nonoperatively with a favorable clinical outcome. They are the Scaphoid, Hamate, Lunate, Trapezium, Trapezoid, Capitate and Pisiform. Typically, the injury is due to hyperextension. The trapezoid is in a relatively immobile, and protected location hence the rarity of an isolated fracture. 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