Comminuted Trapezium Fracture: Case Presentation and Review of Surgical Fixation Techniques

We report a case of a 28-year-old male who sustained a comminuted trapezium fracture with carpometacarpal subluxation of the right hand. Treatment with internal fixation with a headless compression screw resulted in excellent outcomes.

Trapezium and Bennett Fracture – A Rare Base Thumb Fracture Pattern:A Case Report

Introduction: Trapezium fracture is a rare entity whose treatment is controversial. The reported cases range from conservative treatment to surgical treatment with good reported results. Case Report: This paper reports a clinical case of trapezium-metacarpal fracture-dislocation associated with trapezius fracture and Bennett fracture, surgically treated with excellent functional and radiological results. The patient underwent open reduction and internal fixation with two screws, excision of fragments, and reinsertion of the anterior oblique ligament. At the year of follow-up, the patient presented no mobility limitations and recovered grip strength. Conclusion: This case study allows us to conclude that open reduction and internal fixation with screws of the dorsal trapezium ridge fractures with ligament repair of the anterior oblique ligament is a valid treatment with the reproduction of good clinical results. Keywords: Hand surgery, internal fixation, trapezium fracture.

The Uncommon Trapezium Fracture: A Case Series

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.

Trapezium Fracture Associated with Thumb Carpometacarpal Joint Dislocation: A Report of Three Cases and Literature Review

Isolated trapezium fracture in combination with thumb carpometacarpal (CMC) joint dislocation is extremely rare, and no treatment consensus exists. Herein, we report 3 successfully treated cases of isolated trapezium fracture with thumb CMC joint dislocation. While good short-term results have been reported in the literature, the possibility of substantial ligament injuries that can lead to future instability of the thumb CMC joint must be noted. In order to obtain an excellent long-term clinical result, we propose the consideration of the anatomical repair of the CMC joint in terms of both bony and ligamentous structures in cases where instability remains after fracture fixation.

Failure of an uncemented thumb carpometacarpal joint ceramic prosthesis

Thumb carpometacarpal joint replacement is associated with high rates of loosening and failure. We present our results for an uncemented ceramic–ceramic total joint prosthesis with a reverse ball-and-socket design and bioactive coating. Between 2008 and 2012, 29 prostheses were inserted into 28 patients (mean age 63 years) with advanced osteoarthritis. After a mean period of 33 months (range 9–62), 26 patients (27 implants) were available for follow-up. Six months postoperatively, 50% of the patients had radiological evidence of early loosening. Fifteen implants had been removed in 14 patients for aseptic loosening (13) or trapezium fracture (2). The 12 patients whose prosthesis was still in place had a mean visual analogue scale pain score of 1.9 (range 0–6) and a mean Disabilities of the Arm, Shoulder and Hand score of 23 (range 0–73.3). Eleven patients were satisfied with the procedure. The rate of early aseptic failure was unacceptably high. Level of evidence: IV