Triquetral Fracture

The triquetrum is the second most commonly fractured carpal bone. Look for the "pooping duck sign" on lateral x-ray! Here's a quick summary:

• Second most common carpal bone fracture 

• Complications are rare but can include functional deficit and arthritis if missed 

• Look for the "pooping duck sign" on lateral x-ray 

• Mechanism: Fall onto outstretched hand or direct blow to dorsum of the hand 

• Exam: Swelling and tenderness just distal to distal ulna, pain with wrist flexion and extension 

• Possible associated injuries: Perilunate dislocation, distal radius or ulna fractures 

• ED Management: Pain control, immobilize 

• Splint: Volar 

• Ortho consult: No 

• Disposition: Discharge with orthopedic follow-up within 1 week 



MH/CCF/CWRU EM Res @MetroHealth_EM



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