From the Guidelines
Treatment for a triquetral fracture typically involves simple immobilization when fracture fragments are small, nonarticular, or minimally displaced. This approach is supported by the American College of Foot and Ankle Surgeons, as noted in a study published in the American Family Physician 1. The diagnosis of a triquetral fracture is based on a history of trauma and focal pain on palpation, confirmed with radiographic studies.
Key Considerations
- Immobilization is the primary treatment for non-displaced or minimally displaced fractures
- Surgery may be considered for displaced fractures or those with associated ligament injuries
- Pain management and reduction of swelling are crucial in the initial stages of treatment
- Follow-up imaging is necessary to confirm proper healing before advancing activity Some key points to consider in the treatment of triquetral fractures include:
- The use of immobilization to allow for proper healing of the fracture
- The importance of pain management, including the use of acetaminophen or NSAIDs, to reduce discomfort and inflammation
- The need for follow-up imaging to confirm proper healing and to guide the progression of activity
- The potential for surgical intervention in cases where the fracture is displaced or there are associated ligament injuries.
From the Research
Treatment for Triquetral Fracture
The treatment for a triquetral fracture can vary depending on the type and severity of the fracture.
- Nonsurgical management is indicated for most triquetral fractures, which usually results in good outcomes 2.
- Immobilization is often the standard of care for initial treatment of triquetral body fractures 3.
- Dorsal cortical fractures are the most common type of triquetral fracture and are usually benign, often responding well to a short time splint or cast support 4.
- Surgical treatment is indicated for fractures with significant displacement or evidence of instability 2, 4.
- Open reduction and internal fixation may be required for displaced body fractures, often as a result of perilunate instability 4.
- Excision of the ununited distal fragment can be a successful treatment for rare cases of triquetral body fracture nonunions 3.
Types of Triquetral Fractures
There are three main types of triquetral fractures:
- Dorsal cortical fractures: the most common type, usually benign 2.
- Triquetral body fractures: can be problematic, especially if displaced 2, 3.
- Volar cortical fractures: the least common type, can be problematic 2.
Potential Complications
Potential complications of triquetral fractures include: