Trapezoid Stress Fracture in a Weight Lifter

Gyu-Min Kong; Joo-Yong Kim; Dae-Hyun Park; Yong-Uk Kwon; Yang-Hwan Jung

doi:10.4055/jkoa.2015.50.4.342

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Kong, Kim, Park, Kwon, and Jung: Trapezoid Stress Fracture in a Weight Lifter

Case Report

Journal of the Korean Orthopaedic Association 2015; 50(4): 342-347.

Published online: 24 August 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.4.342

Trapezoid Stress Fracture in a Weight Lifter

Gyu-Min Kong, M.D., Ph.D., Joo-Yong Kim, M.D., Dae-Hyun Park, M.D., Yong-Uk Kwon, M.D., Yang-Hwan Jung, M.D.

Department of Orthopedic Surgery, Pusan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Correspondence to: Joo-Yong Kim, M.D. Department of Orthopedic Surgery, Inje University Pusan Paik Hospital, 75 Bokji-ro, Busanjin-gu, Busan 47392, Korea. TEL: +82-51-890-6129, FAX: +82-51-892-6619, honaud0@hanmail.net

Received 25 October 2014 Revised 1 March 2015 Accepted 17 March 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Trapezoid fracture is a rare condition and especially, isolated trapezoid fracture is most rare condition of carpal bone fracture. And principle of treatment has not yet been established. Most of trapezoid fractures can be treated using cast but displaced fracture or fracture combined with other carpal bone fractures may require operative treatment. There have been reports about case of conservative treatment in trapezoid stress fracture but no report about case of operative management. We treated a trapezoid stress fracture in a weight lifting athlete by operative treatment and report the results with literature review.

Keywords: stress fractures, trapezoid bone

Figures and Tables

Figure 1

Plain radiographs demonstrated increased trapezoid density with subchondral sclerosis.

Figure 2

Computed tomography images demonstrated secondary changes. Subtle depressions, collapse and fragmentation.

Figure 3

Magnetic resonance imaging demonstrated wide areas of signal change including low signal intensity on proton density images and increased intensity on T2-weighted images, consistent with avascular necrosis.

Figure 4

Technetium-99m bone scintigraphy demonstrated moderate uptake of right trapezoid bone.

Figure 5

Computed tomography images after 6 weeks of conservative treatment showed no progression of union.

Figure 6

Using a dorsal approach, the fracture site was easily exposed. After removal of a necrotized lesion and confirmed bleeding of fracture surface, autologous bone graft was done. Serial open reduction and internal fixation with screw was performed.

Figure 7

Computed tomography images 6 months after the operation. Note the formation of bony callus.

Figure 8

Computed tomography images 10 months after the operation. Note the progression of bony uinion.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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