Isolated trapezium fractures are uncommon carpal injuries that may be overlooked because of their relatively low frequency, subtle clinical presentation, and anatomical relationship with the thumb carpometacarpal joint. Accurate diagnosis requires appropriate interpretation of clinical findings and imaging, while treatment selection depends on fracture morphology, displacement, articular involvement, and functional requirements. This review critically synthesizes the provided case reports and literature describing isolated trapezium and closely related carpal fractures. The analysis emphasizes diagnostic recognition, fracture characterization, treatment decision-making, and functional considerations. The available literature demonstrates that isolated trapezium fractures can present in diverse morphological patterns, including coronal and comminuted configurations, and that delayed or inadequate recognition may compromise assessment of the articular surface and thumb function. Panigrahi et al. provide an important case-based framework for recognizing an isolated coronal trapezium fracture and integrating radiological assessment with treatment planning (Panigrahi et al., 2015). Other reports contribute evidence regarding isolated trapezium injury in sporting activity and comminuted fracture patterns, while reports of trapezoid fractures provide useful comparative information concerning rare carpal injuries. Overall, the evidence supports a structured diagnostic approach based on mechanism, physical examination, targeted imaging, fracture morphology, and joint involvement. Management should be individualized rather than determined solely by the rarity of the injury. The principal limitation of the current evidence base is its reliance on case reports and small clinical series, restricting the strength of comparative treatment conclusions.