Abstract
Introduction: This study examines triquetral fracture data from six hospital centres between 2009 and 2018. The study focuses on elements of triquetral fracture management within these six centres, outlining common fracture patterns, the short-term and long-term outcomes and the common mechanisms of injury. To the authors’ knowledge, this is the largest cohort of triquetral fractures studied to date and outlines investigation recommendations for improved identification of these fractures. Methods: Data was obtained by reviewing the charts of patients presenting to emergency departments within the Nepean and Blue Mountains local health district of New South Wales, Australia. (Nepean Hospital ethics approval no: NBM18/805) Results: Triquetral fractures can be hard to identify with radiography and can be commonly mistaken as lunate fractures.12 Our results indicate that 18.9 per cent of patients required CT imaging to correctly diagnose triquetral fracture. Conclusion: Where there are ongoing symptoms and a high clinical suspicion of a triquetral fracture, CT may be indicated and, in future practice, may be justified as a first line imaging modality. This study also demonstrates that short arm-wrist immobilsing casts are an effective option for managing triquetral fractures.
Highlights
This study examines triquetral fracture data from six hospital centres between 2009 and 2018
The most common triquetral fracture are volar avulsion fractures, fractures through the triquetral bone and cortical fractures of the dorsal surface of the triquetral.[3,4]. These fractures are attributed to various injuries including compression by a prominent hamate through wrist hyperextension,[5] impaction by the ulnar styloid,[3] and damage to the dorsal cortex of the triquetrum associated with dorsiflexion and ulnar deviation of the wrist.[1,3,6]
A fall from a height ranging from 1.5–5 m accounted for the triquetral fracture for six patients (5.4%)
Summary
This study examines triquetral fracture data from six hospital centres between 2009 and 2018. The study focuses on elements of triquetral fracture management within these six centres, outlining common fracture patterns, the shortterm and long-term outcomes and the common mechanisms of injury. To the authors’ knowledge, this is the largest cohort of triquetral fractures studied to date and outlines investigation recommendations for improved identification of these fractures. High energy direct blows to the wrist can result in a triquetral bone fracture in a number of planes.[5]
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