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Abstract
Purpose
Fractures of trapezium are uncommon carpal bone fractures and often unrecognized lesions. We investigated about operative treatment of trapezium fracture.
Materials and Methods
Seven patients with fractures of trapezium were evaluated after surgical treatment with a mean follow up time of 18 months (12 months~3 years). Functional assessment (pain, limitation in activities of daily living, satisfaction), physical examination (range of motion, grip strength), and radiographic evaluation were performed. Traumatic arthritis and carpometacarpal joint subluxation were confirmed by radiograph.
Results
During study period, 122 cases were carpal bone fractures, and seven of 122 cases were fractures of trapezium. All cases were intra-articular fractures of trapezium. 1st carpometacarpal joint dislocation at 4 patients, Bennett's fracture at 1 patient, hamate hook fracture at 1 patient, and base of 4th proximal phalanx fracture at 1 patient were associated with fracture of trapezium. Open reduction and internal fixation were performed at 6 cases and 1st carpometacarpal joint arthrodesis was performed at 1 case because of neglected fracture. One of 6 cases which were performed to open reduction and internal fixation was reoperated to external fixation due to reduction loss. Clinically 6 patients revealed good results. one of 7 patients experienced limitation of thumb opposition.
Figures and Tables
Fig. 1
(A, B) Radiograph and CT show communited depressed fracture of trapezium.
(C) Immediate postoperative radiograph shows internal fixation with 2 K wires and 1 mini screw.
(D) Anteroposterior radiograph of postoperative 5 weeks shows reduction loss and carpometacarpal subluxation.
(E) Intraoperative photograph shows open reduction using external fixator.
(F) Immediate postoperative radiograph shows open reduction and pinning and external fixation.
(G) Anteroposterior radiograph of postoperative 21 months shows traumatic arthritis.
Fig. 2
(A, B) Radiograph shows communited fracture of trapezium and Bennett's fracture.
(C) Immediate postoperative radiograph shows internal fixation with 6 K wires and 1 mini screw.
(D) Anteroposterior radiograph of postoperative 3 months shows good union status.
Fig. 3
(A) CT shows fracture of trapezium and carpometacarpal joint degenerative arthritis and osteophyte formation.
(B) Immediate postoperative radiograph shows carpometacarpal joint fusion with Acutrak screw.
(C, D) Radiograph and CT show nonunion of carpometacarpal joint fusion.
(E, F) Radiograph of second postoperative 2 months shows good union status.
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