Trapezium Fractures

• The trapezial body is often fractured due to an axial load through the thumb
• The trapezial ridge is often fractured during a fall on an outstretched hand
• Accounts for 1% to 5% of all carpal fractures.

Suspect the Diagnosis when you note

• Tenderness  over trapezium 
• Often have increased pain with axial loading of thumb.
• Point tenderness at the volar base of the thumb just distal to the scaphoid, at the base of the first metacarpal.
• Since the trapezium is obscured by superimposed bones in PA and lateral views, fractures are most easily identified on the oblique radiographs

If you are suspected the diagnosis oblique radiographs or a CT scan of the wrist will note the fracture the best.

Treatment consists of placing the patient in a thumb spica splint.