Treating Triquetrum Fractures: From Splints to Surgery
Treating Triquetrum Fractures: From Splints to Surgery
The Healing Journey
Treating a triquetrum fracture requires a tailored approach based on the fracture type and severity. While most cases heal well with conservative treatment, some may require surgical intervention.
Contents
Initial Management: Rest, Ice, and Immobilization
The first step in treating a triquetrum fracture is to reduce pain and swelling. This typically involves resting the wrist, applying ice, and initial immobilization with a volar splint. The splint is usually applied with the wrist in slight extension, allowing for some compression while still permitting ice application and elevation of the limb.
Conservative Treatment: Casting and Immobilization
For most uncomplicated triquetrum fractures, conservative treatment is the go-to approach. This involves immobilization in a short arm cast for 3-6 weeks, depending on the fracture type. Avulsion fractures typically require 3-4 weeks, while body fractures may need up to 6 weeks. The cast is applied with the wrist in slight extension, leaving the metacarpophalangeal (MCP) joints free to prevent stiffness.
Surgical Intervention: When It's Necessary
Surgery is typically reserved for complicated cases. This includes open fractures, those with significant displacement (2mm or more), or fractures associated with other injuries like perilunate dislocations. The most common surgical approach involves open reduction and internal fixation (ORIF), where the bone fragments are realigned and held in place with screws or pins.
Rehabilitation and Return to Activity
After the immobilization period, rehabilitation is crucial. This often involves a combination of passive stretching and strengthening exercises. A typical program might include wrist flexion, extension, and deviation exercises, along with grip strengthening. Full return to sports or heavy labor is usually possible 1-3 weeks after cast removal, once full range of motion and at least 80% strength are achieved.
FAQs
How long does it take for a triquetrum fracture to heal?
Most fractures heal within 4-6 weeks, but full strength may take several months to return.
Is surgery always necessary for displaced fractures?
Not always, but fractures displaced by 2mm or more often benefit from surgical fixation.
Can I move my fingers while in a cast for a triquetrum fracture?
Yes, and it's encouraged to prevent stiffness in your finger joints.
What complications can occur with triquetrum fracture treatment?
Complications are rare but can include nonunion, stiffness, and occasionally, chronic pain.
How soon can I return to work with a triquetrum fracture?
It depends on your job, but light duty work is often possible after a few weeks.
The Road to Recovery
With proper treatment and rehabilitation, most people with triquetrum fractures can expect a full recovery and return to normal activities.
Additional References
- Urch EY, Lee SK. Clin Sports Med 2015; 34:51.
- Suh N, et al. J Hand Surg Am 2014; 39:785.
- Papp S. Hand Clin 2010; 26:119.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.