Download PDF
CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2023; 51(01): e003-e009
DOI: 10.1055/s-0043-1769599
Original Article

Triquetral Fractures: Bibliographical Review about Four Clinical Cases

Article in several languages: español | English
Yulia Perova 
1   Medicina Familiar y Comunitaria, Centro de Salud Teruel Centro, Teruel
,
Ángel Castro Sauras
2   Servicio de Cirugía Ortopédica y Traumatología, Hospital Obispo Polanco, Teruel
,
Justo Manuel Villalba Garcia
3   FEA Servicio de Urgencias, Hospital Obispo Polanco, Teruel
,
Sandra Rodríguez Martínez
4   Medicina Familiar y Comunitaria, Centro de Salud Ensanche, Teruel
,
Miguel Ranera García
5   FEA Servicio de Cirugía Ortopédica y Traumatología, Hospital Obispo Polanco, Teruel
,
María Royo Agustín
5   FEA Servicio de Cirugía Ortopédica y Traumatología, Hospital Obispo Polanco, Teruel
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Triquetral, or pyramidal, bone fractures are the second most common carpal fracture after scaphoid fractures. They usually result from bone impaction after extension trauma and ulnar deviation of the wrist. These fractures are classified into three groups: triquetral dorsal cortical, body, and volar cortical fractures. The late diagnosis of these injuries is not uncommon since they may go unnoticed during care at the Emergency Services. The early performance of additional radiological tests, such as computed tomography (CT), may avoid late diagnoses. Classically, these fractures have a good prognosis, and their treatment is immobilization. However, magnetic resonance imaging (MRI) can help the diagnosis of associated lesions in cases of poor evolution. The recent literature discusses the different types of surgical procedures available depending on the presence of carpal instability, fibrous pseudoarthrosis, triangular fibrocartilage complex injuries, pisotriquetral arthrosis, etc. The objectives of this study are to compare clinical cases in two distinct profiles of patients presenting the same injury but different evolution and to carry out a complete review on the subject, providing additional information on some triquetral fracture complications.

Keywords

triquetral fractures - carpal instability - wrist

Authorization Letter

All authors declare this paper was not published in other communication media.




Publication History

Received: 30 May 2022

Accepted: 03 May 2023

Article published online:
07 June 2023

© 2023. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Bibliografía

  • 1 M. Court-Brown C.. D. Heckman J, M. McQueen M, M. Ricci W, Tornetta III P. Rockwood and Greeǹs Fractures in Adults, vol. 8. Philadelphia: Wolters Kluwer ed; 2015
    Google Scholar
  • 2 William B, Geissler FS, Joseph FS. Fractures of the carpal bones. Fractures of the triquetrum. En: Greeǹs Operative Hand Surgery. Philadelphia: Churchill Livingstone; 2011. ; 6:680-682
    Google Scholar
  • 3 Athanasiou V, Panagopoulos A, Iliopoulos ID. et al. Intra-articular fracture of the distal part of the triquetrum within the pisotriquetral joint: case report and review of literature. Open Orthop J 2018; 12: 84-90
    CrossrefPubMedGoogle Scholar
  • 4 Guo RC, Cardenas JM, Wu CH. Triquetral Fractures Overview. Curr Rev Musculoskelet Med 2021; 14 (02) 101-106
    CrossrefPubMedGoogle Scholar
  • 5 Domínguez-Gasca LG, Magaña-Reyes J, Domínguez-Carillo LG. Fractura del piramidal. Aten Primaria 2017; 24 (01) 47
    PubMedGoogle Scholar
  • 6 Becce F, Theumann N, Bollmann C. et al. Dorsal fractures of the triquetrum: MRI findings with an emphasis on dorsal carpal ligament injuries. AJR Am J Roentgenol 2013; 200 (03) 608-617
    CrossrefPubMedGoogle Scholar
  • 7 García-Elias M. Carpal Instability. En: Greeǹs Operative Hand Surgery. Philadelphia: Churchill Livingstone.; 2011. ; 6:465-522
    Google Scholar
  • 8 Lee SJ, Rathod CM, Park KW, Hwang JH. Persistent ulnar-sided wrist pain after treatment of triquetral dorsal chip fracture: six cases related to triangular fibrocartilage complex injury. Arch Orthop Trauma Surg 2012; 132 (05) 671-676
    CrossrefPubMedGoogle Scholar
  • 9 Carratalá Baixauli V, Lucas García FJ, Sánchez Alepuz E, Calero Ferrandis R. Dolor en el borde ulnar de la muñeca. Revista Española de Artroscopia y Cirugía Articular. 2014; 21 (01) 77-80
    CrossrefPubMedGoogle Scholar
  • 10 Skalski M, Kusel K. Pooping duck sign. Reference article. 2017 . Disponible en: https://radiopaedia.org/articles/pooping-duck-sign?lang=us
    PubMedGoogle Scholar
  • 11 Suh N, Ek ET, Wolfe SW. Carpal fractures. J Hand Surg Am 2014; 39 (04) 785-791 , quiz 791
    CrossrefPubMedGoogle Scholar
  • 12 Castellanos J, Veras del Monte L. Luxación traumática de la articulación trapeciometacarpiana. Rev Esp Cir Ortop Traumatol 2009; 53 (05) 317-319
    PubMedGoogle Scholar
  • 13 Martínez-Martínez A, García-Espinosa J. Fractura bilateral simultánea del piramidal. Rev Esp Cir Ortop Traumatol 2017; 61 (04) 286-288
    PubMedGoogle Scholar
  • 14 Pineda BA, Bernabé CE, Morales SA. Fractura del hueso piramidal en un paciente pediátrico. Revista de la Facultad de Medicina de la UNAM. 2017; 60 (05) 22-27
    PubMedGoogle Scholar
  • 15 Osca Guadalajara M, Muniesa Herrero P, Castro Sauras Á, Díaz Martínez JV. Paciente con traumatismo y dolor en muñeca. A propósito de dos casos. Revista Atalaya Médica. 2014: 49-52
    Google Scholar
  • 16 Gill TK, Shanahan EM, Allison D, Alcorn D, Hill CL. Prevalence of abnormalities on shoulder MRI in symptomatic and asymptomatic older adults. Int J Rheum Dis 2014; 17 (08) 863-871
    CrossrefPubMedGoogle Scholar
  • 17 Tran G, Cowling P, Smith T. et al. What Imaging-Detected Pathologies are Associated with Shoulder Symptoms and their Persistence? A Systematic Literature Review. Arthritis Care & Research. 2018; 70 (08) 1169-1184
    CrossrefPubMedGoogle Scholar
  • 18 Sajid IM, Parkunan A, Frost K. Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care. BMJ Open Qual 2021; 10 (03) e001287
    CrossrefPubMedGoogle Scholar
  • 19 Schwartzberg R, Reuss BL, Burkhart BG, Butterfield M, Wu JY, McLean KW. High Prevalence of Superior Labral Tears Diagnosed by MRI in Middle-Aged Patients With Asymptomatic Shoulders. Orthop J Sports Med 2016; 4 (01) 2325967115623212
    CrossrefPubMedGoogle Scholar
  • 20 Sánchez A, Salerni H. Retardo de consolidación de fracturas. Actual Osteol 2012; 11 (01) 47-56
    PubMedGoogle Scholar
  • 21 Apergis E. Fracture Dislocations of the Wrist. Springer-Verlag. Italia. 2013: 61-137
    CrossrefGoogle Scholar
  • 22 Durbin FC. Non-union of the triquetrum; report of a case. J Bone Joint Surg Br 1950; 32-B (03) 388
    CrossrefPubMedGoogle Scholar
  • 23 Sin CH, Leung YF, Ip SP, Wai YL, Ip WY. Non-union of the triquetrum with pseudoarthrosis: a case report. J Orthop Surg (Hong Kong) 2012; 20 (01) 105-107
    CrossrefPubMedGoogle Scholar
  • 24 Rasoli S, Ricks M, Packer G. Isolated displaced non-union of a triquetral body fracture: a case report. J Med Case Rep 2012; 6: 54
    CrossrefPubMedGoogle Scholar
  • 25 Niemann MJ, Brooks WC, Cavanaugh P, Lese AB, Taras JS. Priscilla Cavanaugh, Lese AB, Taras JS. Excision of a rare triquetral body fracture nonunion. J Hand Surg Glob Online 2021; 3 (02) 103-105
    CrossrefPubMedGoogle Scholar
  • 26 Esplugas M, Aixalà Llovet V. Lesiones del complejo del fibrocartílago triangular. Tipos de reparación. Revista Español de Artroscopia y Cirugía Articular. 2014; 21 (01) 14-27
    CrossrefPubMedGoogle Scholar
  • 27 Carratalá Baixauli V, Lucas FJ, Calero Ferrandis R, Sánchez Alepuz E. Síndrome de impactación ulnocarpiano, manejo artroscópico. Revista Española de Artroscopia y Cirugía Articular. 2014; 21 (01) 28-36
    CrossrefPubMedGoogle Scholar
  • 28 Miranda I, Lucas FJ, Carratalá V, Ferràs-Tarragó J, Miranda FJ. Anatomic reconstruction of the Triangular Fibrocartilage Complex for the Treatment of Chronic Instability of the Distal Radioulnar Joint. A Systematic Review. Revista Iberoamericana de Cirugía de Mano. 2021; 49 (02) 97-104
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Aiki H, Wada T, Yamashita T. Pisotriquetral arthrosis after triquetral malunion: a case report. J Hand Surg Am 2006; 31 (07) 1157-1159
    CrossrefPubMedGoogle Scholar
  • 30 Carratalá Baixauli V, Pereira AD, Lucas García FJ, Guisasola Lerma E, Martínez Andrade C. Arthroscopic Pisiform Excision in Pisotriquetral Osteoarthritis Technique Using a Direct Pisotriquetral Portal. Tech Hand Up Extrem Surg 2021; 25 (04) 264-268
    CrossrefPubMedGoogle Scholar