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Scaphoid fracture is the most common fracture of the carpal bones. A knowledge of the less common carpal bone fractures and how they are demonstrated is useful for the radiographer working in an acute care facility.
The triquetral is the second most commonly fractured carpal bone. Most of the fractures are dorsal avulsion fractures at the attachment of the radiocarpal ligament. The mechanism of injury is forced hyperflexion. (http://www.gentili.net/fracture.asp?ID=154)
The PA/AP wrist image often does not reveal any clear evidence of a triquetral fracture. This is due in part to the fractures being commonly sited on the dorsal aspect of the wrist and the pisiform is overlying the triquetrum in this projection The oblique wrist image demonstrates a defect in the cortex of the triquetrum The triquetral fracture is most clearly demonstrated on the lateral image (arrowed). Overlying soft tissue swelling supports the diagnosis.