Isolated Trapezoid Fracture in Adolescent Goalkeepers: A Scoping Review of the Literature and a Report of Two Cases.

Autor: Aldeeb M; Department of Medical Education, Family Medicine Residency Program, Hamad Medical Corporation, Doha, Qatar., Aminake GN; Aspetar Orthopedic and Sport Medicine Hospital, Doha, Qatar., Khalil IA; Department of Urology, Hamad Medical Corporation, Doha, Qatar., Hayton M; Department of Orthopedic Surgery, Upper Limb Unit, Wrightington Hospital, Wrightington, UK., Ksantini OEK; Aspetar Orthopedic and Sport Medicine Hospital, Doha, Qatar., Hagert E; Aspetar Orthopedic and Sport Medicine Hospital, Doha, Qatar.; Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
Jazyk: angličtina
Zdroj: Journal of hand surgery global online [J Hand Surg Glob Online] 2023 Oct 31; Vol. 6 (1), pp. 46-52. Date of Electronic Publication: 2023 Oct 31 (Print Publication: 2024).
DOI: 10.1016/j.jhsg.2023.09.001
Abstrakt: Purpose: Isolated trapezoid fractures are rare injuries, particularly among adolescents, constituting only 0.4% of all carpal bone fractures. This study aims to present two cases of isolated trapezoid fracture in adolescent goalkeepers and a scoping review of the literature to provide guidelines for the management of this injury.
Methods: Following PRISMA-ScR guidelines, a scoping review of reported cases was conducted. Two hundred and twenty articles were found using PubMed and Google Scholar. After full-text review, a total of 30 cases from 22 articles along with our 2 cases were analyzed based on demographics, injury mechanism, method/timing of diagnosis, prognosis, and time to recovery.
Results: Thirty-two reported cases of trapezoid fractures with a mean age of 26.7 years (75% male) were found, with pain as the most common presenting symptom. A majority (78%) had initial negative findings on radiography, and the diagnosis was primarily established through computed tomography (59%; n = 19) or magnetic resonance imaging (50%; n = 16). There was a substantial delay in diagnosis (mean 26 days), primarily because computed tomography/magnetic resonance imaging was frequently ordered late. The majority of cases (78%) were managed conservatively, with immobilization periods ranging from 4 to 12 weeks. The average duration for full recovery was 4.5 months, with operative management taking 7.3 months and conservative management taking 3.5 months.
Conclusion: Trapezoid fractures, though rare, are often not promptly diagnosed on initial plain radiographs, leading to a potential underreporting of cases. Because of the risk of complications associated with this type of injury, clinicians should maintain a high level of vigilance and consider trapezoid fracture as a possible differential diagnosis when presented with carpal pain, swelling, or limited movement, particularly after axial load incidents. Further research and guidelines are needed to enhance our understanding and management of this uncommon injury in the future.
Type of Study/level of Evidence: Differential diagnosis/symptom prevalence IIIb.
(© 2023 The Authors.)
Databáze: MEDLINE