Clin Orthop Surg.  2016 Jun;8(2):223-227. 10.4055/cios.2016.8.2.223.

Acute Dislocation of the Metacarpal-Trapezoid Joint

• Cardozo DF
• Plata GV
• Casas JA
• Rodríguez NS

• KMID: 2412351
• DOI: http://doi.org/10.4055/cios.2016.8.2.223

Abstract

The trapezoid metacarpal dislocation is a rare event. In the literature, it is found in case reports. This injury is caused by direct or indirect high energy trauma. In most cases, the dislocation is dorsal and is difficult to reproduce because the joint is not very mobile. Given the low incidence and little evidence supported in the literature regarding the management, this injury can be treated by open or closed reduction; however, it has been published that most authors use Kirschner wire fixation with good results. Here we present our experience in the management of a male patient with acute trapezoid metacarpal dislocation handled with a splint with good functional results at 6 weeks.

Keyword

Carpometacarpal joints; Dislocations

MeSH Terms

Adult
Humans
*Joint Dislocations/diagnostic imaging/therapy
Male
*Metacarpal Bones/diagnostic imaging/injuries/physiopathology
*Metacarpophalangeal Joint/diagnostic imaging/injuries/physiopathology
Splints

Figure

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  Fig. 1 Anterior (A) and lateral (B) views showing loss of integrity of the trapezoid and second metacarpal articulation.

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  Fig. 2 Dorsal trapezoid and second metacarpal ligaments. (1) Ulnar base of the second metacarpal to trapezoid; (2) radial base of the second metacarpal to trapezoid; (3) trapezoid to ulnar base of the third metacarpal; and (4) dorsal intermetacarpal ligament.

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  Fig. 3 "V" shaped interosseous ligament between the second and third metacarpals.

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  Fig. 4 Arrow shows the dorsal prominence over the second metacarpal base ("like a hump").

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  Fig. 5 Anteroposterior radiograph showing the parallel M-line.

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  Fig. 6 A lateral view. Lines are drawn from the volar head to the volar base of the second and fourth metacarpals. The angle should measure between 7° and 11°.

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  Fig. 7 The metacarpal cascade line. The lines are congruent to a radial point, making it normal.

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