Clin Orthop Surg.  2015 Dec;7(4):430-435. 10.4055/cios.2015.7.4.430.

Carpometacarpal Joint Fracture Dislocation of Second to Fifth Finger

• Pundkare G
• Patil AM

• KMID: 2360255
• DOI: http://doi.org/10.4055/cios.2015.7.4.430

Abstract

BACKGROUND
Carpometacarpal joint fracture dislocation of the second to fifth finger is a rare hand injury associated with high energy trauma. Due to severe swelling and overlapping of bones on the radiograph of wrist-hand, dislocations are missed. We reported a series of six patients with rare carpometacarpal joint fracture dislocation treated with open reduction.
METHODS
We retrospectively studied six cases of carpometacarpal joint fracture dislocation. All patients were treated with open reduction and internal fixation with Kirschner wire. Functional assessment was done with Quick Disabilities of the Arm, Shoulder and Hand score (Quick DASH score) at regular intervals.
RESULTS
Average Quick DASH score was improved from 75.76 to 1.9 from 6 weeks to 18 months of duration. Of the six patients, three patients had a Quick DASH score of 0 at the end of 18 months.
CONCLUSIONS
Careful hand examination and radiographic assessment is necessary to avoid missed diagnosis of carpometacarpal joint fracture dislocation. Early open reduction and internal fixation lead to excellent recovery of hand function.

Keyword

Carpometacarpal joints; Volar dislocation; Dorsal dislocation; Fracture

MeSH Terms

Adult
Carpometacarpal Joints/*injuries/radiography/*surgery
Dislocations/radiography/*surgery
Fracture Fixation, Internal
Fracture Healing
Hand Injuries/radiography/*surgery
Humans
Male
Middle Aged
Retrospective Studies
Young Adult

Figure

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  Fig. 1 Anteroposterior, lateral, and oblique radiographic views of left volar fracture dislocation of the second to fifth carpometacarpal joint.

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  Fig. 2 Preoperative clinical photograph of volar carpometacarpal fracture dislocation of the left hand.

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  Fig. 3 Postoperative anteroposterior, oblique, and lateral radiographic views of the left hand.

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  Fig. 4 Six weeks postoperative anteroposterior and oblique views of radiograph of the left hand.

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  Fig. 5 One-year postoperative anteroposterior radiograph of the left hand.

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  Fig. 6 One-year postoperative lateral radiograph of the left hand.

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