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Case Reports
. 2008 Sep;4(2):138-42.
doi: 10.1007/s11420-008-9086-3. Epub 2008 Jul 31.

Volar dislocation of the fourth and fifth carpometacarpal joints: a case report and review of the literature

Peter M Prokopis  1 , Andrew J Weiland
Affiliations
Case Reports

Volar dislocation of the fourth and fifth carpometacarpal joints: a case report and review of the literature

Peter M Prokopis et al. HSS J. 2008 Sep.

Abstract

We report the treatment of a volar dislocation to the fourth and fifth carpometacarpal (CMC) joints. Plain radiographs were used to evaluate this unusual injury before surgery. Open reduction and internal fixation using K-wires restored the normal anatomic relationships of the CMC joints. This very rare injury is often difficult to recognize. A careful neurologic assessment of the patient is a necessity, as well as obtaining proper radiographs of the hand. A review of the literature is presented.

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Figures

Fig. 1
Fig. 1
Preoperative dorsal clinical photo demonstrating significant swelling as well as splaying of the long and ring fingers
Fig. 2
Fig. 2
Preoperative volar clinical photo demonstrating significant swelling as well as splaying of the long and ring fingers
Fig. 3
Fig. 3
Preoperative AP radiograph demonstrating proximal and ulnar displacement of the base of the fifth metacarpal on the hamate as well as an avulsion fracture off of the base of the fourth metacarpal
Fig. 4
Fig. 4
Preoperative lateral radiograph demonstrating volar subluxation of the bases of the fourth and fifth metacarpals
Fig. 5
Fig. 5
Postoperative AP radiograph demonstrating anatomic restoration of the fourth and fifth CMC joints
Fig. 6
Fig. 6
Postoperative lateral radiograph demonstrating anatomic restoration of the fourth and fifth CMC joints
Fig. 7
Fig. 7
Three months postoperative clinical photo demonstrating restoration of full hand motion on the injured side (right) compared to the contralateral (left) side
Fig. 8
Fig. 8
Three months postoperative clinical photo demonstrating restoration of full hand motion on the injured side (right) compared to the contralateral (left) side
Fig. 9
Fig. 9
Three months postoperative AP radiograph demonstrating maintenance of reduction of the fourth and fifth CMC joints
Fig. 10
Fig. 10
Three months postoperative lateral radiograph demonstrating maintenance of reduction of the fourth and fifth CMC joints
See this image and copyright information in PMC

References

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