Bilateral trapezium and multiple metacarpal base fractures: An uncommon case report
Yasin Erdoğan1
, Mert Karaduman2
1Department of Orthopedics and Traumatology, Ankara Etlik City Hospital, Ankara, Türkiye
2Department of Orthopedics and Traumatology, Division of Hand Surgery, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Türkiye
Keywords: Bilateral, metacarpal fracture, trapezium fracture.
Abstract
Although fractures of the trapezium are extremely rare, the bone plays a crucial role in grip and pinch movements of the hand. These fractures may be associated with a concomitant fracture of the first metacarpal base and dislocation of the carpometacarpal joint. A 19-year-old male presented with bilateral hand and wrist pain following a motorcycle accident. Imaging revealed a comminuted Walker type V trapezium fracture and a second metacarpal base fracture on the right side and a non-displaced Walker type IV trapezium fracture with second, third, and fourth metacarpal base fractures on the left. The left trapezium fracture was managed conservatively, while metacarpal fractures were treated with percutaneous Kirschner wire (K-wire) fixation. On the right, closed reduction and percutaneous K-wire fixation were applied for the comminuted trapezium and associated metacarpal base fractures. The patient achieved complete bone union at one-year follow-up with no range of motion limitation. However, hand grip and key pinch strength were below normative values bilaterally, likely due to trauma, with slightly better results on the nonoperatively treated side. In conclusion, this case emphasizes the importance of high clinical suspicion and advanced imaging in the diagnosis of trapezium fractures, particularly in high-energy trauma. Individualized treatment strategies based on fracture type and displacement can result in satisfactory radiological and functional outcomes even in complex bilateral cases.
Citation: Erdoğan Y, Karaduman M. Bilateral trapezium and multiple metacarpal base fractures: An uncommon case report. Jt Dis Relat Surg 2026;37(1):277-281. doi: 10.52312/jdrs.2026.2372.
All authors contributed equally in the writing and evaluation of this manuscript.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The data that support the findings of this study are available from the corresponding author upon reasonable request.