title: Recognition and treatment of uncommon carpal fractures.
abstract: Fractures of the trapezial ridge, hamate hook, and pisiform are often due to isolated, direct injury, but other carpal bone fractures are seldom isolated injuries. Midcarpal fractures should stimulate a search for associated perilunate injury; distal carpal row fractures suggest carpometacarpal fracture--dislocations or subluxations. Crush injury with fracture of the hamate, triquetrum, or trapezium may indicate an axial subluxation of the ulnar or radial carpus. Bone scans can be useful as a screening tool. Diagnosis will often require special radiographic techniques such as tomography. Carpal bone fractures are usually intra-articular, and treatment should be aimed at restoring joint congruity. Small extra-articular fractures and injuries to the pisiform can be successfully treated with excision.
mesh_terms: D002348:Carpal Bones / Q000293:injuries*; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000175:diagnosis* / Q000601:surgery; D006801:Humans