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Carpometacarpal joint dislocation (5th)

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Punched a wall. Now pain and deformity.

Patient Data

Age: 19 years
Gender: Male

Right hand radiographs

x-ray

5th carpometacarpal dislocation with metacarpal volar angulation and small fracture of the medial aspect of the proximal epiphysis. Increased local soft tissue edema. The reminder bones are unremarkable.

Case Discussion

This type of dislocation, although uncommon, has a strong young male prevalence due to its usual mechanism: punching hard structures. As shown in this case, a base of metacarpal fracture is a common association with this injury. 

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