Surgical treatment of isolated trapezoid bone
pseudarthrosis: A case report
Received: 24 October 2014 /Accepted: 8 April 2015 /Published online: 2 May 2015
Springer-Verlag Berlin Heidelberg 2015
Abstract Isolated trapezoid fractures are rarely observed.
Clinical suspicion is necessary for a diagnosis that is usually
delayed or missed. There is no consensus on whether treat-
ment modalities should be conservative or surgical. A 20-year-
old female patient complained of pain, and an MRI examina-
tionshowedanon-unionfracture of the trapezoid bone.
Surgical treatment using a headless cannulated screw and
grafting was performed for trapezoid pseudarthrosis. Clinical
and radiological results were satisfactory.
Level of Evidence: Level V, diagnostic study.
Keywords Trapezoid bone
The trapezoid bone is the smallest bone in the distal row of the
carpal bones. It can be identified by its wedge-shaped form
and has four articular facets: the scaphoid, second metacarpal,
trapezium and capitate. The trapezoid bone is relatively stable
due to its anatomical shape and strong ligamentous connection
with adjacent bone.
Because of its anatomical structure, isolated trapezoid frac-
tures are rare; the incidence is approximately 0.2 % of all
carpal bone fractures [1, 2]. Although primary fractures have
been rarely reported, non-union fractures have not been pre-
viously reported in the literature [1–10]. Both conservative
and surgical treatments have been suggested for treatment,
but a consensus has not been reached because comparative
studies are lacking [3–8].
Herein, we present the results of using surgical treatment to
manage trapezoid bone pseudarthrosis, including a 1 year fol-
A 20-year-old female patient was referred to us 6 months after
falling on her hand. The patient complained of pain, which
caused limited mobility that affected her daily functions. Prior
immobilisation using a short arm-thumb spica was used as a
conservative treatment approach and had resulted in failure.
During clinical examination, she had local tenderness over the
second metacarpophalangeal joint without instability. Irregularity
of the trapezoid bone was detected in the initial radiographs
(Fig. 1). Magnetic resonance imaging (MRI) showed fragmenta-
tion of the trapezoid bone in T1-weighted images and bone mar-
row oedema in T2-weighted images (Fig. 2).
The patient underwent surgical treatment under general an-
aesthesia; surgery was performed through a dorsal incision.
The trapezoid bone was fractured, sclerotic and of normal
Fig. 1 A 20-year-old woman complained of pain. Her AP hand X-ray
was nearly normal (a, b)
* Turgut Akgül
Department of Orthopaedics and Traumatology, Sanlıurfa Training
Hospital, Sanlıurfa, Turkey
Faculty of Medicine, Department of Orthopaedics and Traumatology,
Istanbul University, Istanbul, Turkey
Eur J Plast Surg (2015) 38:419–420