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Bone Hand & Wrist

Triquetrum

os triquetrum

The triquetrum is a pyramid-shaped carpal bone on the medial side of the proximal row that articulates with the pisiform anteriorly and the hamate distally, and bears the impact of ulnar-sided wrist trauma.

Anatomical Data

Structure & Landmarks

Articulations
  • Lunate medially
  • Pisiform anteriorly
  • Hamate distally
  • TFCC superiorly
Landmarks
  • Oval articular facet for pisiform
  • Cartilaginous facet for TFCC
OssificationEndochondral ossification from a single centre appearing at age 3.
Clinical Relevance

Clinical Notes

The triquetrum articulates with the TFCC rather than the radius, making it part of the medial column of the carpus. Triquetrum dorsal chip fractures from dorsal impaction are the second most common carpal fracture after the scaphoid. Lunotriquetral ligament tears from a FOOSH produce ulnar wrist pain reproduced by the lunotriquetral shear test (Reagan ballottement test).

Pathology

Common Injuries & Conditions

Triquetral Dorsal Chip Fracture

The second most common carpal fracture, a small avulsion from the dorsal triquetrum after a fall onto the hand, which usually heals with brief immobilisation.

Lunotriquetral Ligament Injury

Tearing of the ligament between the lunate and triquetrum causes ulnar-sided wrist pain and clicking.

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