Patient: Male, 33 Final Diagnosis: Trapezoid fracture Symptoms: Pain during active flexion/extension of the wrist tenderness at the base of the second metacarpal Medication: — Clinical Procedure: Cast immobilisation Specialty: Orthopedics and Traumatology Objective: Challenging differential diagnosis Background: Trapezoid fractures are very uncommon, accounting for less than 1% of all wrist fractures. Isolated fractures of this bone are even more rare, with just a few reports in the literature. The trapezoid bone has a very stable position within the wrist, forming a relatively immobile joint with the second metacarpal base distally. It is also connected by very strong ligaments to the trapezium, capitate and, scaphoid. Trapezoid fractures occur when a strong bending or axial force is applied to the second metacarpal base. Case Report: We present a clinical case of an isolated, non-displaced, trapezoid fracture in a young white male, which was treated with cast immobilization for 4 weeks and physical therapy. Complete functional recovery was achieved 3 months after the injury, without any pain or tenderness. Conclusions: Fractures of the trapezoid bone usually have a good clinical outcome. Nonetheless, we need to be very suspicious about this diagnosis since radiography is apparently normal in almost all such cases and clinical examination results may not be entirely clear.

HighlightsDistal radioulnar joint arthropathy has multiple causes.Ulnar head excision results in wrist instability and a weak improvement of pain.Ulnar head arthroplasty is a safe and effective procedure.Posterior interosseous nerve neurectomy decreases wrist pain but not proprioception.