Carpometacarpal joint dislocation

Dr Kieran Kusel and Dr Henry Knipe et al.

Carpometacarpal (CMC) joint dislocations are uncommon dislocations of the hand.

There is a strong younger male predominance. These injuries account for less than 1% of hand injuries 4 and are more common in the dominant hand.

Typical mechanism:

  • punching (most common)
  • fall

The patient may present with ulnar deviation of the 5th digit if just the 5th carpometacarpal joint is dislocated. A mass may be present in cases of 3rd, 4th, and 5th joint dislocation. Often the hand is so grossly swollen that these features may not be readily apparent.

Loss of the clear joint space and zigzag or M-shape pattern between the carpals and metacarpals on the PA projection, although this may be sometimes seen in normal patients. The dislocation may only clearly be shown on oblique or lateral projections.

These injuries are usually unstable after reduction and therefore are managed operatively by either closed or open reduction with K-wire fixation. The K-wires are removed after 6 weeks at which time range of movement exercise begins 4

The following injuries should raise the suspicion of carpometacarpal joint dislocations:

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Article information

rID: 23619
Synonyms or Alternate Spellings:
  • CMC dislocation
  • CMC joint dislocation
  • Carpometacarpal dislocation

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Cases and figures

  • Case 1: 5th CMC with base of metacarpal fracture
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  •  Case 2: fracture-dislocation of the 4th and 5th CMC joints
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  • Case 3: CT with hamate fracture
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  • Case 4: dislocation of 4th and 5th CMC joints
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  • Case 5
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  • Case 6: 5th CMC joint dislocation
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  • Case 7: dislocation of all CMC joints
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