Trapezial Fractures and Associated Fractures of the Ulnar Carpus: A Ring-Bone Model.
Journal
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
ISSN: 2474-7661
Titre abrégé: J Am Acad Orthop Surg Glob Res Rev
Pays: United States
ID NLM: 101724868
Informations de publication
Date de publication:
01 03 2023
01 03 2023
Historique:
received:
11
11
2022
accepted:
19
01
2023
medline:
6
4
2023
entrez:
4
4
2023
pubmed:
5
4
2023
Statut:
epublish
Résumé
Fractures of the trapezium are rare; however, the incidence may be under-reported in the literature. The incidence of ulnar-sided carpal body fractures as a concomitant injury has not been reported. Our study aimed to evaluate the incidence of trapezium fractures in conjunction with ulnar-sided carpal body fractures. Over a five-year period, our electronic records were queried and charts reporting carpal bone fractures were reviewed. All cases of trapezium fracture were evaluated further and presented. Eight trapezial fractures were identified, representing 8% of all carpal fractures and 26% of all nonscaphoid carpal fractures. Of the eight trapezium fractures identified, five (62.5%) were associated with Bennett fracture and four (50%) were associated with ulnar-sided carpal fractures. Our study demonstrates a higher incidence of trapezial fractures than previously reported. Previously unreported concomitant ulnar-sided carpal body fractures are reported at a frequency nearly equal to that of concomitant Bennett fractures in our series. We propose a mechanism of injury where the carpal canal and overlying transverse carpal ligament function as a ring-bone construct similar to the pelvis. When a trapezium fracture is identified, we recommend additional evaluation for ulnar-sided injuries of the carpus.
Sections du résumé
BACKGROUND
Fractures of the trapezium are rare; however, the incidence may be under-reported in the literature. The incidence of ulnar-sided carpal body fractures as a concomitant injury has not been reported. Our study aimed to evaluate the incidence of trapezium fractures in conjunction with ulnar-sided carpal body fractures.
METHODS
Over a five-year period, our electronic records were queried and charts reporting carpal bone fractures were reviewed. All cases of trapezium fracture were evaluated further and presented.
RESULTS
Eight trapezial fractures were identified, representing 8% of all carpal fractures and 26% of all nonscaphoid carpal fractures. Of the eight trapezium fractures identified, five (62.5%) were associated with Bennett fracture and four (50%) were associated with ulnar-sided carpal fractures.
CONCLUSION
Our study demonstrates a higher incidence of trapezial fractures than previously reported. Previously unreported concomitant ulnar-sided carpal body fractures are reported at a frequency nearly equal to that of concomitant Bennett fractures in our series. We propose a mechanism of injury where the carpal canal and overlying transverse carpal ligament function as a ring-bone construct similar to the pelvis. When a trapezium fracture is identified, we recommend additional evaluation for ulnar-sided injuries of the carpus.
Identifiants
pubmed: 37014747
doi: 10.5435/JAAOSGlobal-D-22-00270
pii: 01979360-202304000-00001
pmc: PMC10082304
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.
Références
Borgeskov S, Christiansen B, Kjær A, Balslev I: Fractures of the carpal bones. Acta Orthop Scand 1966;37:276-287.
Dennis HHW, Sze ACK, Murphy D: Prevalence of carpal fracture in Singapore. J Hand Surg Am 2011;36:278-283.
Van Onselen EBH, Karim RB, Hage JJ, Ritt MJPF: Prevalence and distribution of hand fractures. J Hand Surg Br 2003;28:491-495.
Bousselmame N, Kasmaoui H, Galuia F, Lazrak K, Taobane H, Moulay I: Fractures of the trapezium [French]. Acta Orthop Belg 2000;66:154-162.
Cordrey LJ, Ferrer-Torells M: Management of fractures of the greater multangular. Report of five cases. J Bone Joint Surg Am 1960;42:1111-1118.
Garcia-Elias M, Henriquez-Lluch A, Rossignani P, Fernandez de Retana P, De Elízaga JO: Bennett's fracture combined with fracture of the trapezium. A report of three cases. J Hand Surg Br 1993;18:523-526.
Harbison S: Simultaneous trapezium and Bennett's fractures. J Hand Surg Am 1993;18:546.
McGuigan FX: Simultaneous trapezium and Bennett's fractures. J Hand Surg Am 1993;18:944.
Radford P, Wilcox D, Holdsworth B: Simultaneous trapezium and Bennett's fractures. J Hand Surg Am 1992;17:621-623.
Walker JL, Greene TL, Lunseth PA: Fractures of the body of the trapezium. J Orthop Trauma 1988;2:22-28.
Botte MJ, Von Schroeder HP, Gellman H, Cohen MS: Fracture of the trapezial ridge. Clin Orthop Relat Res 1992;276:202-205.
Jensen BV, Christensen C: An unusual combination of simultaneous fracture of the tuberosity of the trapezium and the hook of the hamate. J Hand Surg Am 1990;15:285-287.
McClain EJ, Boyes JH: Missed fractures of the greater multangular. J Bone Joint Surg Am 1966;48:1525-1528.
Ohshio I, Ogino T, Miyake A: Dislocation of the hamate associated with fracture of the trapezial ridge. J Hand Surg Am 1986;11:658-660.
Palmer AK: Trapezial ridge fractures. J Hand Surg Am 1981;6:561-564.
Destot E: The classic: Injuries of the wrist: A radiological study. New York, NY: Paul B. Hoeber; 1926. Clin Orthop Relat Res 2006;445:8-14.
Kindl J: Isolierte Handwurzelknoebenverletzungen. Beitraege Klin Chir 1910;67:549-569.
Pointu J, Schwenck JP, Destree G, Sejourne P: Fractures of the trapezium. Mechanisms. Anatomo-pathology and therapeutic indications [French]. Rev Chir Orthop Reparatrice Appar Mot 1988;74:454-465.
McGuigan FX, Culp RW: Surgical treatment of intra-articular fractures of the trapezium. J Hand Surg Am 2002;27:697-703.
Dunn AW: Fractures and dislocations of the carpus. Surg Clin North Am 1972;52:1513-1538.
Hove LM: Fractures of the hand. Distribution and relative incidence. Scand J Plast Reconstr Surg Hand Surg 1993;27:317-319.
Raghupathi AK, Kumar P: Nonscaphoid carpal injuries—Incidence and associated injuries. J Orthop 2014;11:91-95.
Beekhuizen SR, Quispel CR, Jasper J, Deijkers RLM: The uncommon trapezium fracture: A case series. J Wrist Surg 2020;9:63-70.
Ladd AL: Guest editorial: The Robert's view: A historical and clinical perspective. Clin Orthop Rel Res 2014;472:1097-1100.
Abbitt PL, Riddervold HO: The carpal tunnel view: Helpful adjuvant for unrecognized fractures of the carpus. Skeletal Radiol 1987;16:45-47.
Failla JM, Amadio PC: Recognition and treatment of uncommon carpal fractures. Hand Clin 1988;4:469-476.
Hodgkinson JP, Parkinson RW, Davies DRA: Simultaneous fracture of the carpal scaphoid and trapezium—A very unusual combination of fractures. J Hand Surg Br 1985;10:393-394.
Neidhardt JH, Morin A, Guelpa G, Cuilleret J, Febvez M, Ounoughene N: Fractures of the trapezium (considerations on a series of 7 personal cases and review of the literature [French]. Lyon Med 1968;219:1049-1064.
Lang G, Kehr P, Sejourne P, Pointu J: A rare lesion : Fracture of the trapezius. Report of one case (author's transl) [French]. Ann Chir 1977;31:350-356.