The trapezium is the most lateral distal carpal bone, articulating with the scaphoid, trapezoid, and the first metacarpal at the saddle-shaped carpometacarpal joint of the thumb, the most mobile joint in the wrist region.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | Endochondral ossification from a single centre appearing at age 5. |
The trapezium articulates with the first metacarpal in the saddle-shaped CMC joint that allows thumb opposition. Trapezium fractures can involve the ridge (which forms the radial wall of the carpal tunnel) or the body, and body fractures sometimes accompany Bennett fractures. Trapezial ridge fractures are associated with carpal tunnel syndrome from haematoma. First CMC joint osteoarthritis (basal thumb arthritis) is one of the most common sites of hand osteoarthritis, producing basal thumb pain and instability in women over 50. When conservative care fails, trapeziectomy, often with ligament reconstruction and tendon interposition using part of the FCR tendon (LRTI), gives reliable pain relief.
Osteoarthritis of the trapeziometacarpal joint is very common in postmenopausal women, causing pain at the base of the thumb with pinching and gripping.
A fall or direct blow can fracture the ridge of the trapezium where the flexor retinaculum attaches, causing pain at the base of the thenar eminence.
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