Abstract
Background Isolated trapezium fractures are rare and account for only 1 to 5% of all carpal
fractures but are still the third most common carpal fracture. Trapezium fractures
are hard to detect and easily missed on standard radiographs. Trapezium fractures
can be treated conservatively, as well as operatively, the best treatment is still
debatable. Damage of the joint surface between the trapezium and the base of the first
metacarpal or scaphoid could cause pain and restriction of movements. Therefore, it
is important to diagnose and treat the fracture at early stage, so that articular
congruence is guaranteed.
Case description We present four cases of the uncommon trapezium fracture. All four cases are conservatively
treated with good results, there was no need for operative treatment in all the cases.
Literature review The literature describes the possibility to use fixation techniques, only when it
is not possible to reduce the displaced fracture or the residual articular step-off
is too high a fixation technique should be used.
Clinical relevance Primarily, we would recommend navicular cast immobilization for 4 to 6 weeks as initial
treatment.
Keywords
trapezium - fracture - uncommon - conservative treatment - casting
