Trapezius and hamate body fractures. Case report of a rare association.

Abstract

The trapezium is the most radial and mobile bone in the distal row of the carpus, establishing a proximal joint with the scaphoid and a distal one with the first metacarpal. Isolated trapezium fractures are uncommon, accounting for only 1 to 5% of all carpal fractures. Fractures are often associated with other injuries, including the rare hamate body fracture. At initial presentation, diagnosing those fractures can be challenging as clinical findings are often minimal, without obvious deformities. Crushing injuries are frequently associated with trapezium tuberosity fractures while hamate body fractures are commonly caused by direct impacts. We report the case of a 19-year-old man presenting significant pain in his left hand following a motorcycle accident 30 minutes ago. Physical examination shows swelling, local hematoma and inability to move the hand. Radiography shows no detectable fracture lines. CT scan reveals a hamate bone fracture without apparent misalignment and a type I trapezium tuberosity base fracture. He made a conservative treatment with analgesic medication and immobilization with a forearm-palmar immobilization for one month followed by two months of physiotherapy. At the end of the two-month treatment, the patient exhibits normal mobility and pain-free, returning to usual activities.