Isolated dislocation of the trapezoid bone. Axial fractures and dislocations can be complicated by associated neurovascular, muscular, and/or tendinous injury. 602-604. Dislocation of the either the trapezium or the trapezoid are both rare injuries, even among carpal dislocations. Chir Organi Mov (Bologna), 65 (1979), pp. We report a case of an isolated, nondisplaced trapezoid fracture that was sustained by direct trauma and subsequently treated successfully in a short-arm cast. This row is closely approximated to the metacarpal bones. This fracture typically occurs due to direct trauma to the hand or wrist. Fractures of the capitate can be part of a greater arch perilunate injury or a consequence of a crush injury to the wrist with multiple bones involved. J Hand Surg1980;5:874-8. Trapezoid bone fracture is the least common fracture owing to the fact that it is strictly bounded to scaphoid, capitate and the base of the second metacarpal. J Hand Surg, 5 (1980), pp. J Bone Joint Surg AM1971;19:576-83. Google Scholar. Each carpal bone presents with a different complexity of problems should it become fractured and these are often related to interruption to their blood supply. L Peretti, C MassazzaAn unusual case of dislocation of the trapezoid bone. 11. There were also mild radial subluxations of the third and fourth metacarpals. Fall on an outstretched hand; Sports injuries; Vehicular accidents ; Physical combat; Direct hit … Mechanisms of injury have typically been reported as an axial load, with or without forced wrist flexion/extension, that is transmitted from the second metacarpal indirectly to the trapezoid. [2] It is also called the lesser multangular bone. The shape and size of this bone and its location below the thumb cause the integrity of the trapezium to deteriorate over time. The trapezoid bone (lesser multangular bone) is a carpal bone in tetrapods, including humans. Triquetrum fractures are the second least common fractures among carpal bones. Two weeks after injury, he presented at our hospital with mild swelling on the dorsal radius of the right wrist and tenderness at the snuff box. Distally from the scaphoid is the trapezium. Clinical Relevance Dorsal dislocation of the trapezoid with its associated second metacarpal is a rare, high-energy injury that can often be missed on plain radiography. 89-92 . J Hand Surg 5: 602–604. 5. It is conservatively treated without dislocation. The eight carpal bones that form the wrist joint are named as the Capitate, Trapezoid, Hamate, Pisiform, Trapezium, Lunate, Scaphoid and Triquetrum. Advertisement . PMID: 18984327 [Indexed for MEDLINE] Publication Types: Case Reports; MeSH … The wrist series examines the carpal bones (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate and hamate), the radiocarpal joint and the distal radius and ulna. The condition may also be accompanied by ligament and nerve damage. H MilchIsolated luxation of the lesser multangular. An alternative mechanism of palmar trapezoid dislocation is postulated to occur by forced hyperextension of the wrist . metacarpal bone was dorsally subluxed and had migrated proxi- Thirty-three cases of this injury have been previously de- mally. Gelberman RH, Panagis JS, Taleisnik J, Baumgaertner M. The arterial anatomy of the car-pus: part II – the intraosseous vascularity. A variant of this injury also involving a fracture of the trapezoid is termed transtrapezoid peritrapezium axial radial fracture dislocation . Computed tomography obtained due to concern for an occult fracture revealed a comminuted fracture of the trapezoid bone involving the articular surface with an anteriorly displaced bone fragment (Figures 1 and 2). ... Avascular necrosis after treatment of trapezoid dislocations may occur as the bone is often enucleated with no soft tissue attachments, but this does not preclude a good result [5, 8, 26, 30, 31, 38, 47]. J Bone Joint Surg [Am] 72: 446–448 . The square bone that bridges the proximal and distal half of the wrist is the pisiform. It is associated with other bony or ligamentous injuries in the wrist. We report a case of combined volar trapezium dislocation and dorsal trapezoid dislocation with other concomitant injuries. Anatomy . We report a case of combined volar trapezium dislocation and dorsal trapezoid dislocation with other concomitant injuries. The second Dislocation of the trapezoid is a very uncommon injury. Trapezium Bone Anatomy and Structure Surfaces and Articulation. This patient's treatment is compared to the few previously published reports of palmarly dislocated trapezoids to assist hand surgeons facing this uncommon injury. The angular shaped bone visible dorsally is the triquetrum. We herein report a case of a trapezoid frac-ture and dorsal dislocation of the lunate. 9. Google Scholar 10. Rhoades CE, Reckling FW (1983) Palmar dislocation of the trapezoid. The bones of wrist and hand collectively form the wrist. If the dislocation includes the trapezium, trapezoid, and the first and second metacarpals, then it is termed peritrapezoid peritrapezium axial radial dislocation (Figs 1d, 7). MA Meyn, AM RothIsolated dislocation of the trapezoid bone. Dislocation of the either the trapezium or the trapezoid are both rare injuries, even among carpal dislocations. The trapezium also touches two other bones in the wrist joint, the scaphoid and trapezoid bones. The trapezium bone is a small oblong bone which plays a role in the stability of the carpal tunnel as well as the stability of the thumb joint. The lunate acts as a central anchor for the carpal bones. Bull Hosp Jt Dis Orthop Inst, 4 (1943), pp. Background: The trapezoid is the least commonly fractured carpal bone, comprising 4% of all carpal fractures. The scaphoid links the two rows of carpals. Axial dislocation and fracture dislocation. The patient was placed in a sugar-tong splint and given orthopedic follow up. Meyn MA Jr, Roth AM (1980) Isolated dislocation of the trapezoid bone. The trapezoid-metacarpal joint dislocation is a rare event because of the stability of the joint,1-8) and there are only few case reports in the literature. Wrist views are requested when injury to the distal radius/ulna or carpal bones are suspected. Displacement of any of these bones may result in Wrist Dislocation. [1] It is a wedge-shaped carpal bone that resembles the trapezium. Below is a systematic approach to interpretation. A trapezoid is constrained and received external force without being dispersed, so it is possible that the axial load to the second metacarpal bone by punching was transmitted to the scaphoid via the trapezoid, leading to the fractures. The proximal surface of the trapezium, in combination with the surface of the trapezoid, forms a slightly concave facet for articulating with the distal surface of the scaphoid [11]. It is the smallest bone in the distal row of carpal bones that give structure to the palm of the hand. Due to the inherent tight structure of the carpals the circulation can quickly become impaired and lead to avascular necrosis 6. We present the case of a 50-year-old worker, who sustained a crush injury of his left hand with a dorsal fracture dislocation of the trapezoid bone and the associated second metacarpal bone at the STT, and a concomitant compartment syndrome of the hand. Causes. 36-40. If there is sustained pain in the wrist and hand after punching, combined trapezoid and scaphoid fractures should be considered as the possible injury. Isolated fractures are rarely seen and usually related to the high energy trauma. The anatomy of each bone will be examined here, and then the basic anatomy of the STT joint will be described to help the reader understand the genesis of STT arthritis. Google Scholar 11. 10. A 29-year-old man sustained injury when he hit the back of his right hand hard on a steel shelf while running in a dark warehouse. Isolated fractures of the capitate are infrequent, representing 2% of carpal fractures. The carpus is held together by firm ligaments which envelope the carpal bones and protect it from damage. The word trapezoid is derived from the Greek word trapezion which means “a little table” of “irregular quadrilateral”. Because of its well-protected position in the wrist, traumatic lesions of the trapezoid bone are rare. J Hand Surg 1983;8:375-82. A review of the literature regarding trapezium and trapezoid dislocations as well as the treatment of these injuries is presented. Stein AH. Case Report. The trapezium articulates with two of the carpal bones, the scaphoid, and the trapezoid as well as with the first metacarpal bone [7].. Bones can sustain stress fractures (thin hairline breaks), or complete avulsion or dislocation. The authors report two cases of isolated, undisplaced, fractures of the trapezoid bone. The lunate bone is central join of carpal bones. Scaphoid Bone Articular Surface Anatomy. Dislocation of the trapezoid has been reported in 30 patients; fractures are seen even less frequently and usually go with dorsal displacement. This wrist bone resembles a medium cashew in size and shape ... the lunate, capitate, trapezoid, and trapezium, along with the lower arm bone radius. Stein AH Jr (1971) Dorsal dislocation of the lesser multangular bone. Isolated fractures of the trapezoid bone have been rarely reported in the literature, the mechanism of injury being an axial or bending load transmitted through the second metacarpal. This injury is caused by direct or indirect trauma that results in posterior disloca-tion in the majority of cases. The anatomy of the scaphoid, trapezium, and trapezoid and the articulations between these three carpal bones are unique and help explain why these three bones are often involved in arthritis of the wrist. Palmar dislocation of the trapezoid is a rare injury, which results from substantial trauma to the wrist. Looking through that, one can see the convexity of the scaphoid. The carpal bones are scaphoid, pisiform, trapezium, lunate, trapezoid, capitate, triquetrum, and hamate. Arthrodesis is recommended over excision because the latter may lead to metacarpal migration and subsequent carpal arthritis. Dorsal dislocation of the lesser multan-gular. The proximal surface has a triangular smooth and convex facet, articulating with the distal end of the radius [3]. The scaphoid bone is joined with both rows of carpal bones. The trapezium is located most radially. Google Scholar. Dorsal and volar extrinsic liga-ments connect the carpal bones with the radius and ulna whereas the intrinsic liga-ments interconnect carpal bones. Additionally, a small avulsion fracture at the scribed in the world literature. The side of the bone … fracture or dislocation. Lunate is the semilunar bone that fits in the distal radius. The distal row consists of the hamate, capitate, trapezoid and trapezium. We report a rare variant with no concomitant injury to the metacarpals or carpal bones. The structure of the trapezoid bone forms a firm, stationary joint with the second metacarpal base. To date, few articles have been published on isolated trapezoid fractures. The trapezoid bone is one of eight carpal bones that forms part of the wrist joint. We report a new combination of these injuries where fracture-dislocation of the base of the 1st metacarpal bone occurred simultaneously with a comminuted fracture of the trapezium, dislocation of the trapezoid and metacarpal joints (2nd to 5th) and an avulsion fracture of the hamate. A trapezoid fracture is a break in the trapezoid bone of the wrist. Google Scholar 9. J Hand Surg 8: 85–88. The trapezoid is shaped like a wedge. We report an unusual variant of a palmar trapezoid dislocation with a shearing fracture of the dorsal cortex treated with mini-fragment screw fixation. Because of its well-protected position in the wrist, traumatic lesions of the trapezoid bone are rare. trapezoid bone and the strong ligament attachments with adjacent bones. Google Scholar. Late presentation of trapezoid dislocation may include avascular necrosis. The condition may also be accompanied by ligament and nerve damage treatment is compared to the distal or! 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