Triquetral Fracture

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Triquetral Fracture

  1. 1.  20 YOM presents with left wrist pain. Pt was playing baseball. He was sliding into second base head first and when his left hand impacted the base he had immediate pain. He is able to move his wrist but has moderate pain. There is swelling over the dorsal surface of his wrist.  T 98.7 P 102 BP 126/84 O2     99% Gen: WDWN, obvious pain CV: Tachycardic, RR, no m/r/g Pulm: Lungs CTA bilat Musc: L wrist swelling over the dorsal surface; TTP just distal to the ulnar styloid process; limited ROM 2/2 pain
  2. 2.  Avulsion fracture of the dorsal ridge of the triquetrum
  3. 3.  Pain Control  Reduction/Stabilization  Splinting of the wrist with volar splint for 4-6 weeks  Orthopedic surgery follow up for re-evaluation and possible ORIF for displaced triquetral body fractures (associated with significant ligamentous injury)
  4. 4.  Second most common fracture of the carpal bones  Results from either direct blow on dorsal surface or fall on outstretched hand (FOOSH, believed to impact the triquetrum against the ulnar styloid process)  May be difficult to identify. May only be visualized as a small fleck on the lateral view
  5. 5.  http://www.feinberg.northwestern.edu/emergencyme     d/residency/orthoteaching/wrist/case30/case30histor y-physicalexam.html http://nypemergency.org/radiology/radiology_2011/ca se-of-the-month-0211.html http://radiographics.rsna.org/content/28/6/1771.figure s-only http://www.abhamed.net/uploads/DOCS/Books/Radi ology/MER2/htm/MER2/HTML/206.htm Rosen’s Emergency Medicine. Chapter 48 Wrist and Forearm.

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