Dislocation of all (first through fifth) carpometacarpal joints

Case contributed by Dalia Ibrahim


Hand trauma

Patient Data

Age: 20-year-old
Gender: Male
  • Dorsal dislocation of the 1st through to the 5th carpo-metacarpal joints associated with multiple fracture as follows:
    • Mildly displaced fracture of the hook of the hamate bone.
    • Fracture of the trapezium and trapezoid bones with multiple adjacent bone fragments.
    • Avulsion fracture of the lateral aspect of the base of the 5th metacarpal bone which is displaced laterally.
  • Comminuted impacted fracture of the 5th metacarpal neck showing mild bone displacement and angulation.
  • Comminuted fracture of the middle phalanx of the ring finger showing mild volar angulation and minimal bone displacement.
  • Intact distal radius and ulna.
  • Diffuse soft tissue edema and swelling of the periarticular muscle groups with preserved intervening fat planes.

Case Discussion

An interesting rare case of (ALL) 1st through to the 5th carpo-metacarpal joint dorsal dislocation. 

Carpo-metacarpal joint dorsal dislocation usually occurs when the hand is forcibly palmar flexed.

Most dislocations are accompanied by fractures of either the involved metacarpals, carpals, or both secondary to the force which causes this type of dislocations.

These type of injuries can be missed secondary to the extensive swelling and edema of the hand.

Lateral radiograph is accurate diagnose this type of injury. 

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