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Fracture, Carpal Bone (Other), Sports Medicine

Thomas Trojian, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Fracture of the carpal bones of the wrist, excluding those of the hamate and scaphoid

  • Includes Kienböck disease, a disease of the lunate where the blood supply is compromised, and pos...

DIAGNOSIS

HISTORY

  • Athletes usually present with a fall on the outstretched hand in the hyperextended position. However, direct trauma or a fall on a flexed wrist can also cause a fracture.

  • Pain and rest...

TREATMENT

  • Immobilization of the wrist should eliminate the pain of the fracture.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and rarely opioids can be added as needed.

  • There are theoretical concerns a...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Any displaced fracture of the carpal bones should be referred to an orthopedic surgeon.

  • Lunate fractures may develop AVN (Kienböck disease) and should be considere...

REFERENCES

1
Johnson BK, Brou L, Fields SK, et al. Hand and wrist injuries among us high school athletes: 2005/06–2015/16. Pediatrics.  2017;140(6):e20171255.
2
Suh N, Ek ET, Wolfe SW. Carpal fractu...

ADDITIONAL READING

  • Duckworth AD, Ring D. Carpus fractures and dislocations. In: Court-Brown C, Heckman JD, McKee M, et al, eds. Rockwood and Green’s Fractures in Adults. 8th ed. Philadelphia, PA: Wo...

CLINICAL PEARLS

  • Frequency of fracture seen in carpal bones is scaphoid 80%, triquetrum 6%, hamate 5%, trapezium 4%, lunate 3%, capitate 1%, and trapezoid and pisiform, <1% each.

  • Dorsal rim chips of ...

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