Nondisplaced fractures are treated conservatively with casting, while displaced fractures are usually surgically fixated (Davis, 2017).
Clinical Presentation Clinical presentation is often nonspecific, which may delay diagnosis (Davis, 2017). Patient reports may include sudden onset of pain and swelling in the hypothenar region of the hand after trauma. Other times, such as with stress fractures, gradual onset of pain over weeks to month is reported. Ring and small finger paresthesias may be reported. Handgrip weakness and the presence of the Tinel sign over the hypothenar eminence may be found with clinical examination (Davis, 2017). Clinicians should inquire about sports participation as well as occupational activities that would cause microtraumas, such as hammering, shoveling, and painting. Clinical Presentation Patients with a triquetral fracture will complain of ulnar- sided wrist pain that increases with wrist flexion and extension (Guo et al., 2021). Dorsal swelling may be present (Guo et al., 2021) as well as tenderness with palpation over the dorsal aspect of the triquetrium (Gil & Weiss, 2020). Diagnosis is confirmed with imaging (Guo et al., 2021).
Triquetral fracture The triquetrum is part of the transverse carpal arch (Guo et al., 2021) where it articulates with the lunate laterally, the pisiform anteriorly, and the hamate distally ( Triquetrum , n.d.). Triquetral fractures account for about 15% of carpal fractures. Dorsal triquetral fractures are the result of axial loading to the extended and ulnarly deviated wrist (Gil & Weiss, 2020), often a fall on an outstretched hand (Guo et al., 2021).
THUMB FRACTURE
Fractures to the thumb can lead to a significant decrease in hand function. This will limit both daily activities and Bennett fracture A Bennett fracture is an oblique intraarticular fracture at the base of the first metacarpal of the thumb that separates the volar–ulnar aspect of the metacarpal base from the remaining distal metacarpal shaft. The volar–ulnar aspect Rolando fracture Rolando fractures are less common than Bennett fractures, but they are more severe fractures of the metacarpal base of Boxer’s fracture A Boxer’s fracture is a fracture of the subcapital aspect/neck of the fifth metacarpal. It is named for the classic mechanism of injury, which is punching with a clenched fist. Direct trauma to the dorsum of the hand, such as falling hard on a closed fist, is another cause (Hussain et al., 2020) and is where this type of fracture earned its name—as it was most Metacarpal fracture Because of the superficial nature of the metacarpal bones and the use of the hand for evasive/protective maneuvers during trauma, fractures to these bones are relatively common. Metacarpal fractures are classified according to the site of injury: Head, neck, shaft, or base of the metacarpal. The fracture pattern may be classified as transverse, short oblique, long oblique, or comminuted (Carreño et al., 2020).
occupational activities for patients, such as opening jars and gripping objects.
is held in place by the volar anterior oblique ligament. The distal fragment is retracted proximally via tension from the abductor pollicis tendon. Surgical fixation is indicated if a significant articular step-off is present.
the thumb. It is an intraarticular fracture with three or more segments. Surgical treatment is indicated.
common amongst boxers and professional fighters. Plain radiographs are used to diagnose this condition (Mohamed et al., 2022). Conservative management is indicated for simple aligned fractures, while surgery is indicated for complex angulated fractures (Hussain et al., 2020).
Clinical Presentation Clinical presentation includes swelling and tenderness over the dorsum of the hand. Deformity of the fingers may be obvious. If a rotation deformity is present, the overriding of the finger, one over the other, may be present. The presence of rotational deformity can be confirmed by asking the patient to flex the fingers. Normally, all fingers point toward the scaphoid tuberosity, but in the presence of a rotational metacarpal fracture, scissoring of the fingers becomes obvious (Carreño et al., 2020). Tuft fracture The most common phalangeal fracture is a tuft fracture, where the tip of the distal phalanx breaks off, followed by fractures to the base of the second phalanx (Kremer et al., 2022).
Phalangeal fracture Young males and elderly females are most susceptible to phalangeal fractures, often during sports activities. The two most common mechanisms of injury are a direct blow or an accidental fall. The lateral two digits are most susceptible to this injury.
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