First carpometacarpal dislocation

Case contributed by Leonardo Lustosa


Fall from standing height onto the thumb.

Patient Data

Age: 40 years
Gender: Female

Hand radiographs revealed a first (thumb) carpometacarpal joint dislocation. The thumb is volar and radially dislocated. No fractures are seen.

Case Discussion

Pure first/thumb carpometacarpal joint dislocations are very rare injuries, in contrast with the much more common Bennett fracture, in which there is an associated fracture of the thumb metacarpal base.

These dislocations are usually the result of axial loading with flexion of the thumb metacarpal.

Optimal management of such injuries is still a subject of debate.

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