From a survey of the literature it would appear that fractures of the greater multangular are less rare than was anticipated. They usually occur in association with other fractures about the wrist.
Analysis of the fractures reported in the literature disclosed no agreement as to the treatment of choice.
Longitudinal fractures of the greater multangular, in our experience and from study of available published roentgenograms, are unstable and are accompanied by subluxation of the first metacarpal.
Since clinical findings are relatively minimum, accurate diagnosis is dependent on adequate roentgenograms. An oblique projection is necessary to obtain a true anteroposterior view of the greater multangular.
To achieve a stable, anatomical reduction of the fracture and assure restoration of the articular surfaces of the first carpometacarpal joint, open reduction and internal fixation are recommended.