Bilateral carpometacarpal dislocations of the thumb

Abstract

In this article, we present a case of traumatic bilateral trapeziometacarpal joint dislocations treated successfully with closed reduction and immobilization. We also review the literature, describe a treatment protocol for management of trapeziometacarpal dislocations, and recommend conservative treatment for patients who have such injuries and who meet certain criteria. Conservative treatment includes immediate diagnosis and stabilization after acute reduction and then use of immobilization to maintain stabilization. Failure to maintain closed reduction, acute instability, significant swelling, or delayed presentation warrants fixation, possibly with percutaneous pinning, and then immobilization in a thumb spica cast. Loss of reduction after pinning, or failure to achieve anatomic reduction, requires open reduction, possibly with acute ligamentous reconstruction.