From the Guidelines
The treatment for a non-displaced triquetrum fracture typically involves simple immobilization, as this approach is appropriate for small, nonarticular, or minimally displaced fracture fragments. This recommendation is based on the principles outlined in the study by the American College of Foot and Ankle Surgeons, although it focuses on heel pain, the general approach to managing non-displaced fractures can be applied 1. The immobilization can be achieved with a short arm cast or a wrist splint for a period of 4-6 weeks.
During the immobilization period, it is crucial to keep the wrist in a neutral or slightly extended position to facilitate proper bone healing. For pain management, over-the-counter medications such as acetaminophen (500-1000mg every 6 hours as needed) or NSAIDs like ibuprofen (400-600mg every 6-8 hours with food) can be used if not contraindicated. Additional measures to reduce swelling and pain include applying ice for 15-20 minutes several times a day during the initial days and elevating the wrist above heart level.
After the immobilization period, patients should start gentle range-of-motion exercises and gradual strengthening, potentially under the guidance of a physical therapist. The triquetrum's good blood supply generally allows for good healing of non-displaced fractures with conservative treatment. However, if pain persists beyond 8-12 weeks or if follow-up X-rays show inadequate healing, further evaluation may be necessary. Patients should be informed that complete recovery can take 3-4 months, though most daily activities can be resumed earlier.
From the Research
Treatment for Non-Displaced Triquetrum Fracture
- The treatment for non-displaced triquetrum fractures typically involves conservative management, with the primary goal of immobilizing the injured wrist to allow for proper healing 2, 3.
- Immobilization of the injured wrist for 3-6 weeks is often recommended, with some studies suggesting that a shorter period of immobilization (3 weeks) may be sufficient for non-displaced fractures 2, 4.
- Non-surgical management is indicated for most triquetral fractures, which usually results in good outcomes 5.
- The use of a short-arm cast or splint is commonly used for immobilization, and the patient should be monitored for any signs of complications, such as non-union or instability 6, 3.
- It is essential to thoroughly evaluate the fracture to determine the best course of treatment, as some fractures may require surgical intervention if there is significant displacement or evidence of instability 5, 3.