What is the typical return to work timeframe for a patient with a triquetral (wrist bone) fracture?

Return to Work After Triquetral Fracture

Most patients with triquetral fractures can return to light work within 2-3 weeks and full work within 3-6 weeks, depending on the type of fracture and job demands.

Healing Timeline

Dorsal Chip Fractures (Most Common)

• Immobilization period: 3 weeks with conservative treatment using a volar splint or short-arm cast 1, 2
• Bone fragment healing: 6-8 weeks if the fragment heals 1, 2
• Return to light work: 2 weeks for mostly sitting work with restrictions on lifting (not exceeding 10 kg) and limiting standing/walking on uneven surfaces 3
• Full return to work: 3-4 weeks depending on specific job requirements 3

Body Fractures (Less Common)

• Immobilization period: 4-6 weeks for non-displaced body fractures 4
• Complete healing: 6-8 weeks with osseous consolidation occurring in all body fractures 2
• Return to light work: 3-6 weeks with similar restrictions as chip fractures 3
• Full return to work: 6-8 weeks depending on job demands and physiotherapy results 3

Factors Affecting Return to Work Timeline

Job-Related Considerations

• Sedentary work (mostly sitting, minimal lifting): Earlier return possible at 2-3 weeks 3
• Physical labor (heavy lifting, standing, uneven surfaces): Delayed return until 6-8 weeks 3
• Manual dexterity requirements: May require additional time for full functional recovery 1

Fracture-Related Factors

• Displacement: Non-displaced fractures heal faster and allow earlier return to work 4
• Associated injuries: Tears of dorsal carpal ligaments, pisiform subluxation, or FCU dislocation prolong recovery 5
• Intra-articular involvement: May require extended immobilization up to 6 weeks 5

Clinical Monitoring and Progression

During Immobilization (0-3 weeks for chip fractures, 0-6 weeks for body fractures)

• Maintain immobilization in short-arm cast or volar splint 1, 5
• Monitor for persistent pain that may indicate complications 6

Post-Immobilization Phase (Weeks 3-8)

• Progressive return to wrist motion: Begin after cast removal 5
• Strengthening exercises: Start after initial motion is restored, typically 5 weeks post-injury 5
• Radiographic follow-up: Confirm healing at approximately 3 weeks and at cessation of immobilization 6

Return to Work Algorithm

1. Week 2-3: Light work for chip fractures with restrictions (sitting work, <10 kg lifting) 3
2. Week 3-4: Full return for sedentary jobs with chip fractures 3
3. Week 6: Light work for body fractures 3
4. Week 6-8: Full return for physical labor or body fractures 3

Common Pitfalls to Avoid

Premature Return to Work

• Returning to heavy manual labor before 6 weeks risks delayed union or persistent pain 1
• Inadequate immobilization (less than 3 weeks for chip fractures) may prevent proper healing 2

Delayed Diagnosis

• Triquetral fractures require high clinical suspicion and proper imaging including oblique wrist x-rays and CT scan 5
• Delayed diagnosis can lead to painful nonunion, persistent instability, and late pisotriquetral arthritis 5

Overlooking Complications

• Unremitting pain during follow-up warrants reevaluation for potential complications 6
• Associated ligamentous injuries (lunotriquetral ligament) may require longer recovery 4

Prognosis

Excellent outcomes are expected with conservative treatment 1, 2. Complete resolution of pain and excellent wrist motion and function typically occur by 3 months, with Mayo scores of 100 reported at one year 5. Post-traumatic instability is not observed, and avascular necrosis is not a concern due to good vascularization 1, 2. All body fractures result in osseous consolidation with appropriate treatment 2.