Fracture of the triquetral

The triquetrum is the second most commonly fractured carpal bone, comprising 15–18% of all carpal bone fractures. The triquetral bone may be fractured by violent hyperextension of the wrist and fractures are more commonly caused by impaction by adjacent bony structures or avulsion of attached ligaments rather than a direct blow, as the surrounding carpal bones protect the triquetrum from direct impact.

Radiography provides the diagnosis although there is no single best view for detecting all variants of triquetral fractures and multiple radiographs should be evaluated together.

Triquetral fractures can be treated satisfactorily with analgesia and immobilization in most cases. They respond favourably to immobilization for 4–6 weeks as they become an asymptomatic fibrous union. In this way, most triquetral fractures are well tolerated even without a true bony union.

Surgical treatment should be considered for fractures with significant displacement or those associated with fracture dislocation concerning for instability.

Reference

1. Guo R et al. Triquetral Fractures Overview. Curr Rev Musculoskelet Med. 2021 Jan 23;14(2):101–106.