- Distal radius fracture
- Extensor carpi ulnaris subluxation
- Lunatotriquetral ligament injury
- Triquetral Avulsion Fracture
- Ulnar extrinsic ligament tear
The image shows that the patient suffered a triquetral avulsion fracture. This is the second-most common fracture involving the carpal bone (the scaphoid being the most common).
Learnings/What to Look for
- Mechanism for triquetral avulsion fracture is often a fall onto an outstretched hand in ulnar deviation
- This fracture can be subtle and is usually visible only on the lateral view
- Typically, this is seen as an avulsed flake of bone, identified lying posteriorly to the triquetral bone in the dorsal mid-wrist
Pearls for Urgent Care Management and Considerations for Transfer
- The wrist should be placed in a cast, either in the urgent care center or by an orthopedic specialist, for approximately 6 weeks
- Rarely, surgical intervention may be necessary. A persistently symptomatic chip fracture may require excision
- Posttreatment, the patient should receive physical therapy
Acknowledgment: Images courtesy of Teleradiology Specialists.