Clin Orthop Surg.  2012 Sep;4(3):246-248. 10.4055/cios.2012.4.3.246.

Bilateral Carpometacarpal Joint Dislocations of the Thumb

• Jeong C
• Kim HM
• Lee SU
• Park IJ

• KMID: 1392989
• DOI: http://doi.org/10.4055/cios.2012.4.3.246

Abstract

A traumatic carpometacarpal joint dislocation of the thumb accounts for less than 1% of all hand injuries. Optimal treatment strategies for this injury are still a subject of debate. In this article, we report a case of bilateral thumb carpometacarpal joint dislocations: a unique combination of injuries. We believe our case is the second report of bilateral carpometacarpal joint dislocation regarding the thumb in English literature. It was successfully treated with closed reduction and percutaneous K-wires fixation on one side, and an open reduction and reconstruction of the ligament on the other side.

Keyword

Bilateral; Carpometacarpal joint; Dislocation; Thumb

MeSH Terms

Bone Wires
Carpometacarpal Joints/*injuries/*surgery
Dislocations/*surgery
Hand Injuries/*surgery
Humans
Male
Middle Aged
Thumb/*injuries/*surgery

Figure

• 

  Fig. 1 Radiographs of both hands showed a dislocation of the carpometacarpal joint in both thumbs with a tiny fracture fragment in the right hand.

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  Fig. 2 Closed reduction and percutaneous K-wires fixation were performed in the right hand (A). Also, open reduction and ligamentous reconstruction were performed in the left hand (B).

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  Fig. 3 Intraoperative photographs for the reconstruction of the volar oblique ligament according to the Eaton and Littler technique. (A) Radial half of the flexor carpi radialis (black star) was passed through a drill hole in the base of the first metacarpal bone (MC). (B) It was placed beneath the abductor pollicis longus (white arrow) and then passed around the remaining flexor carpi radialis (white arrow head) and secured over the dorsal capsule.

Reference

1. Mueller JJ. Carpometacarpal dislocations: report of five cases and review of the literature. J Hand Surg Am. 1986. 11(2):184–188.

2. Bosmans B, Verhofstad MH, Gosens T. Traumatic thumb carpometacarpal joint dislocations. J Hand Surg Am. 2008. 33(3):438–441.

3. Bettinger PC, Linscheid RL, Berger RA, Cooney WP 3rd, An KN. An anatomic study of the stabilizing ligaments of the trapezium and trapeziometacarpal joint. J Hand Surg Am. 1999. 24(4):786–798.

4. Khan AM, Ryan MG, Teplitz GA. Bilateral carpometacarpal dislocations of the thumb. Am J Orthop (Belle Mead NJ). 2003. 32(1):38–41.

5. Johnson SR, Jones DG, Hoddinott HC. Missed carpometacarpal dislocation of the thumb in motorcyclists. Injury. 1987. 18(6):415–416.

6. Chen VT. Dislocation of the carpometacarpal joint of the thumb. J Hand Surg Br. 1987. 12(2):246–251.

7. Eaton RG, Lane LB, Littler JW, Keyser JJ. Ligament reconstruction for the painful thumb carpometacarpal joint: a long-term assessment. J Hand Surg Am. 1984. 9(5):692–699.

8. Shah J, Patel M. Dislocation of the carpometacarpal joint of the thumb: a report of four cases. Clin Orthop Relat Res. 1983. (175):166–169.

9. Watt N, Hooper G. Dislocation of the trapezio-metacarpal joint. J Hand Surg Br. 1987. 12(2):242–245.

10. Simonian PT, Trumble TE. Traumatic dislocation of the thumb carpometacarpal joint: early ligamentous reconstruction versus closed reduction and pinning. J Hand Surg Am. 1996. 21(5):802–806.