Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Mar 10:5:16.
doi: 10.1186/1749-799X-5-16.

Isolated thumb carpometacarpal joint dislocation: a case report and review of the literature

Elias Fotiadis  1 , Theodoros Svarnas, Christos Lyrtzis, Alexis Papadopoulos, Panagiotis Akritopoulos, Byron Chalidis
Affiliations

Isolated thumb carpometacarpal joint dislocation: a case report and review of the literature

Elias Fotiadis et al. J Orthop Surg Res. .

Abstract

Background: Isolated thumb carpometacarpal dislocation is a rare injury pattern and the optimal treatment option is still controversial.

Case description: We present a 27-year-old basketball player who underwent an isolated dorsal dislocation of the thumb carpometacarpal joint after a fall. The dislocation was successfully reduced by closed means but the joint was found to be grossly unstable. Due to inherent instability, repair of the ruptured dorsoradial ligament and joint capsule was performed.The ligament was detached from its proximal insertion into trapezium and subsequently stabilized via suture anchors. The torn capsule was repaired in an end-to-end fashion and immobilization of the joint was applied for 6 weeks.

Results: At 3-year follow up evaluation the patient was pain free and returned to his previous level of activity. No restriction of carpometacrpal movements or residual instability was noticed. Radiographic examination showed normal joint alignment and no signs of subluxation or early osteoarthritis.

Conclusion: Surgical stabilization of the dorsal capsuloligamentous complex may be considered the selected treatment option in isolated carpometacarpal joint dislocations, that remain unstable after closed reduction in young and high demand patients.

Level of clinical evidence: Level IV.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Anteroposterior radiograph of the right hand. Isolated thumb CMC joint dislocation is evident.
Figure 2
Figure 2
Intraoperative photograph of the dorsal aspect of carpometacarpal joint. The dorsoradial ligament (black arrow) has been detached from its attachment to trapezium. The capsule (double white arrow) has been also transversely torn exposing the joint and the base of 1st metacarpal (white arrow).
Figure 3
Figure 3
Appearance of the right hand 3 years post-operatively. The patient had normal and painless thumb movement.
Figure 4
Figure 4
Anteroposterior radiograph of the right hand 3 years post-operatively. Good joint congruency without signs of instability or osteoarthritis are seen.
See this image and copyright information in PMC

References

    1. Bosmans B, Verhofstad MHJ, Gosens T. Traumatic thumb carpometacarpal joint dislocations. J Hand Surg. 2008;33A:438–441. - PubMed
    1. Chen VT. Dislocation of the carpometacarpal joint of the thumb. J Hand Surg (Br) 1987;12(2):246–51. - PubMed
    1. Jacobsen CW, Elberg JJ. Isolated carpometacarpal dislocation of the thumb. Scand J Plast Reconstr Surg. 1988;22:185–186. doi: 10.3109/02844318809072395. - DOI - PubMed
    1. Neumann DA, Bielefeld T. The carpometacarpal joint of the thumb: Stability, deformity and therapeutic intervention. J Orthop Sports Phys Ther. 2003;33(7):386–399. - PubMed
    1. Bettinger PC, Linscheid RL, Berger RA, Cooney WP, An KN. An anatomic study of the stabilizing ligaments of the trapezium and trapeziometacarpal joint. J Hand Surg [Am] 1999;24(4):786–798. doi: 10.1053/jhsu.1999.0786. - DOI - PubMed