Open AccessAn Uncommon Presentation of Fracture-dislocation of the 4th and 5th Carpometacarpal Joints with Volar Displacement and its Management
Author(s) -
Nikhil Jawaharlal,
Vasanthakumar Ramsingh,
Vijaya Bhalaik
Publication year - 2021
Publication title -
journal of orthopaedic case reports
Language(s) - English
Resource type - Journals
eISSN - 2321-3817
pISSN - 2250-0685
DOI - 10.13107/jocr.2021.v11.i09.2400
Subject(s) - medicine , carpometacarpal joint , reduction (mathematics) , kirschner wire , displacement (psychology) , percutaneous pinning , wrist , dislocation , fixation (population genetics) , dorsum , surgery , radiography , fracture (geology) , orthodontics , internal fixation , anatomy , osteoarthritis , psychology , population , materials science , geometry , alternative medicine , mathematics , environmental health , pathology , geotechnical engineering , engineering , composite material , psychotherapist
Introduction: Carpo-metacarpal joint fracture-dislocations are rare injuries. They constitute less than 1% of all hand injuries [1]. They often go unnoticed [2]. Of these, dorsal fracture-dislocations on the ulnar side are more commonly seen [3] because of the greater stabilizing dorsal structures. Volar fracture-dislocations are very rare and difficult to diagnose for which, one should have a keen eye on.Case Report: This is a case of a 51-year-old female with a closed injury to her wrist. With clinical suspicion and appropriate radiographs fracture-dislocation of the 4th and 5th carpometacarpal joints with volar displacement was diagnosed. She underwent closed reduction and percutaneous Kirschner wire fixation, followed by 6 weeks of immobilization. At the final follow-up in 4 months, the patient was noted to have a satisfactory outcome following intense physiotherapy.Conclusion: Fourth and fifth carpometacarpal joint fracture-dislocations of the fingers are unique; their diagnosis can be challenging and often overlooked [4], which if missed can have very poor outcomes. The functional prognosis depends on the precocity of diagnosis and appropriate reduction and vigorous rehabilitation.Keywords: Carpometacarpal joint, fracture-dislocation, volar displacement, wrist injury.