Transverse carpal ligament disruption associated with simultaneous fractures of the trapezium, trapezial ridge, and hook of hamate: A case report

Carpal Bone Fractures

“…She remained unhappy, and litigation was considered because of the delay in diagnosis. Combination injuries including trapezial ridge fractures and hook of hamate fractures secondary to avulsion from the transverse carpal ligament have been reported also [49]. These injuries may be missed on normal radiologic review.…”

Transverse carpal ligament tear at the trapezial ridge without fracture - the “trapezial ridge line” sign: two case reports

“… 1 Multiple articles describe avulsion fractures associated with the transverse carpal ligament attachment to the hamate and trapezium. 4,5 One article has documented a tear of the transverse carpal ligament attachment at the hook of the hamate, without an accompanying fracture of the hamate, which was described as a focal linear area of high signal intensity on fluid-sensitive MRI sequences within the medial attachment of transverse carpal ligament. This was coined the ‘hook line’ sign or the ‘Salil-Zhang-Abhinav’ sign by the authors.…”

“…It is important to differentiate these entities as a fracture is likely to heal in 6 weeks whilst a ligament tear may take a longer timeframe to recuperate and may require a longer period of immobilisation in a cast. 4,7 A tear without fracture is also occult on CT but detectable on MRI.…”

Sonography of trapezial ridge fractures

“…T rapezial fractures are uncommon with trapezial ridge fractures being even rarer. [1][2][3][4][5][6][7][8][9] These fractures are due to direct trauma as seen following a fall on an outstretched hand or by indirect trauma (ie, secondary to excessive tension of the transverse carpal ligament, which is attached to the trapezial ridge) 10,11 (Figure 1). These can easily be overlooked on standard radiographs unless there is a high index of clinical suspicion and further imaging performed.…”