Triquetral Fractures: A Comprehensive Review of Pathophysiology, Diagnostic Techniques, and Treatment Strategies

Triquetral fractures, although the second most common carpal bone fractures, can be difficult to accurately diagnose and treat. This review explores the complex landscape of triquetral fractures and proposes guidelines for the optimal management of the condition. A comprehensive literature search of PubMed, Scopus, Cochrane Library, ScienceDirect, and Web of Science was performed from January 1901 to June 2026 using the terms "Triquetral Fracture" OR "Triquetrum Fracture" AND "Pathophysiology," "Diagnosis," "Investigation," "Treatment," OR "Management." Studies addressing the mechanisms, diagnosis, or management of triquetral fractures were included. Animal studies, non-English articles, and studies without full-text access were excluded. Twenty-nine studies were included. Evidence supported differing management strategies according to fracture type, displacement, and associated injuries. Areas of consensus regarding diagnosis and treatment were identified, alongside important gaps in the literature. Management is guided by fracture pattern and stability. Non-displaced fractures are generally treated conservatively with 3 to 6 weeks of immobilization, whereas displaced fractures, non-unions, and associated ligamentous injuries may require surgical intervention. Persistent pain or functional impairment warrants further investigation. Additional research is needed to refine treatment recommendations.