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J Wrist Surg
DOI: 10.1055/s-0044-1788639
Case Report

Operative Treatment of an Isolated, Comminuted, Biarticular Trapezium Fracture: A Case Report and Review of the Literature

Sandie Eiras
1   Department of Orthopaedic, University of Nicosia Medical School, Nicosia, Cyprus
,
Gregorios Bolgouras
2   Department of Orthopaedic, Limassol General Hospital, Limassol, Cyprus
,
Christos Panayiotou
2   Department of Orthopaedic, Limassol General Hospital, Limassol, Cyprus
,
Zacharias Alexandrou
2   Department of Orthopaedic, Limassol General Hospital, Limassol, Cyprus
,
Costas Papakostidis 
2   Department of Orthopaedic, Limassol General Hospital, Limassol, Cyprus
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Abstract

Background Isolated, highly comminuted trapezium fractures are extremely rare. While they can be initially diagnosed with plain radiographs, a computed tomography scan of the wrist will more clearly reveal the fracture details and aid in appropriate preoperative planning. Restoration of the fracture with a congruent reduction of the adjacent joints is mandatory for a favorable prognosis.

Case Description A case of a highly comminuted, biarticular, trapezium fracture in a young male patient that was treated operatively with open reduction and internal fixation (ORIF) with a cannulated miniscrew and an additional Kirschner wire (K-wire) is presented. Restoration of a decent intra-articular congruity of the trapezium with both the base of the first metacarpal distally and the scaphoid bone proximally ensured a favorable outcome.

Literature Review Various operative techniques are presented in current literature, encompassing ORIF with screws and K-wires, closed reduction and percutaneous fixation with K-wires, mini-external fixation, button fixation, and arthroscopically assisted percutaneous fixation. A favorable prognosis is documented in cases where a congruous reduction of the fracture was achieved and maintained throughout the healing period.

Clinical Relevance We feel that a formal ORIF is the procedure of choice for highly comminuted trapezium fractures, as they are not easily amenable to accurate reduction by means of closed methods.

Keywords

trapezium - comminuted - fracture - operative treatment

Ethical Approval

The present research was approved by the Institutional Review Board.




Publication History

Received: 18 April 2024

Accepted: 25 June 2024

Article published online:
18 July 2024

© 2024. Thieme. All rights reserved.

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