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.
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. Trapezium ridge fractures are associated with carpal tunnel syndrome from haematoma. First CMC joint osteoarthritis (basal thumb arthritis) affecting the trapezium-metacarpal interface is one of the most common joints affected by osteoarthritis, producing the classic basal thumb pain and instability pattern in women over 50.
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