Trapezium fracture
Background
- Occurs via direct blow to thumb or dorsiflexion and radial deviation force
- Major complication is nonunion
Clinical Features
- Painful thumb movement
- Weak pinch
- TTP at apex of anatomic snuffbox, base of thenar eminence
Differential Diagnosis
Evaluation
- Hand x-ray (best seen on 20-degree pronated oblique view)
Trapezium fracture
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Immobilization
- Short arm thumb spica splint
Disposition
- Discharge with close hand/ortho follow up
Specialty Care
- Displaced fracture >1mm or diastasis >2mm require surgery
See Also
References
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