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Joint Diseases and
Related Surgery
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Case Report · Open access

Bilateral trapezium and multiple metacarpal base fractures: An uncommon case report

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Yasin Erdoğan

Department of Orthopedics and Traumatology, Ankara Etlik City Hospital, Ankara, Türkiye

ORCID: 0000-0001-6862-9671

Mert Karaduman

Department of Orthopedics and Traumatology, Division of Hand Surgery, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Türkiye

ORCID: 0000-0003-1136-411X

Abstract

Although fractures of the trapezium are extremely rare, the bone plays a crucial role in grip and pinch movements of the hand. These fractures may be associated with a concomitant fracture of the first metacarpal base and dislocation of the carpometacarpal joint. A 19-year-old male presented with bilateral hand and wrist pain following a motorcycle accident. Imaging revealed a comminuted Walker type V trapezium fracture and a second metacarpal base fracture on the right side and a non-displaced Walker type IV trapezium fracture with second, third, and fourth metacarpal base fractures on the left. The left trapezium fracture was managed conservatively, while metacarpal fractures were treated with percutaneous Kirschner wire (K-wire) fixation. On the right, closed reduction and percutaneous K-wire fixation were applied for the comminuted trapezium and associated metacarpal base fractures. The patient achieved complete bone union at one-year follow-up with no range of motion limitation. However, hand grip and key pinch strength were below normative values bilaterally, likely due to trauma, with slightly better results on the nonoperatively treated side. In conclusion, this case emphasizes the importance of high clinical suspicion and advanced imaging in the diagnosis of trapezium fractures, particularly in high-energy trauma. Individualized treatment strategies based on fracture type and displacement can result in satisfactory radiological and functional outcomes even in complex bilateral cases.

Declarations

Author Contributions

All authors contributed equally in the writing and evaluation of this manuscript.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Urch EY, Lee SK. Carpal fractures other than scaphoid. Clin Sports Med 2015;34:51-67. DOI: 10.1016/j.csm.2014.09.006.
  2. Vigler M, Aviles A, Lee SK. Carpal fractures excluding the scaphoid. Hand Clin 2006;22:501-16. DOI: 10.1016/j.hcl.2006.07.007.
  3. Cooney WP 3rd, Chao EY. Biomechanical analysis of static forces in the thumb during hand function. J Bone Joint Surg Am 1977;59:27-36.
  4. Özdemir A, Şahin E, Durgut F, Acar MA. Volar buttress plate fixation: An effective and reliable option for Bennett's fractures. Jt Dis Relat Surg 2024;35:177-85. DOI: 10.52312/jdrs.2023.1427.
  5. Mohammed S, Mouncef A, Walid B, Amin H, Mohammed B, Abdelkrim D. Surgical treatment for the uncommon bi-articular fracture of trapezium: A case report. Clin Case Rep 2023;11:e7118. DOI: 10.1002/ccr3.7118.
  6. Kose O, Keskinbora M, Guler F. Carpometacarpal dislocation of the thumb associated with fracture of the trapezium. J Orthop Traumatol 2015;16:161-5. DOI: 10.1007/s10195-014-0288-9.
  7. Tsyrulnik A. Emergency department evaluation and treatment of wrist injuries. Emerg Med Clin North Am 2015;33:283-96. DOI: 10.1016/j.emc.2014.12.003.
  8. Inston N, Pimpalnerkar AL, Arafa MA. Isolated fracture of the trapezium: An easily missed injury. Injury 1997;28:485- 8. DOI: 10.1016/s0020-1383(97)00169-1.
  9. Ladd AL, Weiss AP, Crisco JJ, Hagert E, Wolf JM, Glickel SZ, et al. The thumb carpometacarpal joint: Anatomy, hormones, and biomechanics. Instr Course Lect 2013;62:165-79.
  10. Walker JL, Greene TL, Lunseth PA. Fractures of the body of the trapezium. J Orthop Trauma 1988;2:22-8. DOI: 10.1097/00005131-198802000-00006.
  11. Beekhuizen SR, Quispel CR, Jasper J, Deijkers RLM. The uncommon trapezium fracture: A case series. J Wrist Surg 2020;9:63-70. DOI: 10.1055/s-0039-1683846.
  12. McGuigan FX, Culp RW. Surgical treatment of intraarticular fractures of the trapezium. J Hand Surg Am 2002;27:697-703. DOI: 10.1053/jhsu.2002.33705.
  13. Chammas PE, Teissier J, Chiche L, Lazerges C, Coulet B, Chammas M. Revision of trapeziometacarpal arthroplasty. Hand Surg Rehabil 2025;44:102066. DOI: 10.1016/j.hansur.2024.102066.
  14. Balci A, Basara I, Çekdemir EY, Tetik F, Aktaş G, Acarer A, et al. Wrist fractures: Sensitivity of radiography, prevalence, and patterns in MDCT. Emerg Radiol 2015;22:251-6. DOI: 10.1007/s10140-014-1278-1.
  15. Ramoutar DN, Katevu C, Titchener AG, Patel A. Trapezium fracture - a common technique to fix a rare injury: A case report. Cases J 2009;2:8304. DOI: 10.4076/1757-1626-2-8304.
  16. Du W, Cornett KMD, Donlevy GA, Burns J, McKay MJ. Variability between different hand-held dynamometers for measuring muscle strength. Sensors (Basel) 2024;24:1861. DOI: 10.3390/s24061861.
  17. Fallahi AA, Jadidian AA. The effect of hand dimensions, hand shape and some anthropometric characteristics on handgrip strength in male grip athletes and non-athletes. J Hum Kinet 2011;29:151-9. DOI: 10.2478/v10078-011-0049-2.
  18. El-Gohary TM, Abd Elkader SM, Al-Shenqiti AM, Ibrahim MI. Assessment of hand-grip and key-pinch strength at three arm positions among healthy college students: Dominant versus non-dominant hand. J Taibah Univ Med Sci 2019;14:566-71. DOI: 10.1016/j.jtumed.2019.10.001.
  19. Ekşioğlu M. Normative static grip strength of population of Turkey, effects of various factors and a comparison with international norms. Appl Ergon 2016;52:8-17. DOI: 10.1016/j.apergo.2015.06.023.