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As you were directed here from our poster Accessory carpal bones – Still enigmatic in 2026 presented in Basel, you are likely seeking more information about os styloideum and its fracture. 🙂
Fracture of the os styloideum is a rare injury of the dorsal wrist. The os styloideum is an accessory ossicle located in the region of the carpometacarpal junction, most commonly between the capitate, trapezoid, and the bases of the second and third metacarpals. Although it may remain asymptomatic and be identified only incidentally, it can also become clinically relevant in the setting of trauma or chronic mechanical irritation.
This injury typically presents with dorsal wrist pain, localized tenderness, and swelling after trauma, often following a fall on the outstretched hand. Its diagnosis may be challenging because conventional radiographs do not always clearly distinguish a fractured os styloideum from other accessory ossicles, anatomical variants, or fractures involving the adjacent metacarpal bases. Cross-sectional imaging, particularly CT, may therefore be important for accurate characterization of the lesion and its anatomical relationships.
Management depends on the clinical presentation, fragment morphology, associated injuries, and persistence of symptoms. In selected cases, conservative treatment with immobilization and gradual return to activity may be sufficient. In patients with ongoing pain, mechanical symptoms, or associated carpal boss pathology, surgical treatment may be considered.
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Do not hesitate to contact us!
Vojtech.kunc@lfmotol.cuni.cz
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