Postoperative Therapy for Chronic Thumb Carpometacarpal (CMC) Joint Dislocation

Wollstein, Ronit; Michael, Dafna; Harel, Hani

doi:10.5014/ajot.2016.017210

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Wollstein et al described the case of a chronic, recurrent thumb CMC dislocation treated with trapeziectomy and a modified LRTI. [26] At work and in the office, that patient's preoperative dislocation was reducible with effort, but demonstrated a natural tendency to dislocate, as was the case with our patient. Wollstein et al highlight the role of attentive postoperative hand therapy to address soft tissue imbalances at the CMC joint, likely coincident with and related to the pathophysiology of thumb osteoarthritis itself.…”

Section: Discussionsupporting

confidence: 69%

Thumb metacarpal dislocation after trapeziectomy with ligamentous reconstruction and tendon interposition: A case report

Weber

Frankenhoff²

2022

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Thumb carpometacarpal (CMC) arthritis is one of the most common and debilitating pathologies evaluated by the hand surgeon, affecting up to 35% of individuals over 55 years of age. Though multifactorial in etiology, dorsal and radial subluxation of the thumb CMC due to incompetency of the volar beak ligament is thought to be among the most important factors contribution to the arthritis. Multiple operative interventions have been proposed to best address this pathology. In the United States, trapeziectomy with ligament reconstruction and tendon interposition (LRTI) as described by Burton and Pellegrini remains the most widely used technique. As an isolated trauma, dislocation of the thumb CMC joint is a rare injury, only comprising approximately 1% of injuries evaluated by hand surgeons. Typically, thumb CMC dislocations occur due to axial load with the thumb in a flexed position. They are most commonly dorsal dislocations, and are thought to occur due to failure of the dorsoradial ligament. To date, no cases of CMC dislocation after LRTI have yet been described in the literature. Here we present a patient with volar thumb CMC dislocation as a rare complication after LRTI. After percutaneous pinning and immobilization followed by hand therapy, the patient has had a successful return to work with improved pain, restored function, and no further instability.

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Section: Discussionsupporting

confidence: 69%

Thumb metacarpal dislocation after trapeziectomy with ligamentous reconstruction and tendon interposition: A case report

Weber

Frankenhoff²

2022

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“…Other cases describing chronic dislocations of the thumb CMC joint classify chronic as anywhere from 30 days to over a year [ 14 , 15 ]. Mazhar et al reviewed nine cases of thumb CMC dislocation, three of which were chronic.…”

Section: Discussionmentioning

confidence: 99%

Chronic Dislocation of the Thumb Carpometacarpal Joint: A Case Report

Kelmer¹,

Johnson²,

Turcotte³

et al. 2023

Cureus

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Dislocation of the thumb carpometacarpal (CMC) joint is a rare injury; chronic CMC dislocation can lead to significant disability. Traditionally, surgical intervention has focused on the reconstruction of the anterior oblique ligament, though more recently there has been more focus on the dorsoradial ligament. Consideration of both ligaments during CMC joint reconstruction is important to optimize functional outcomes.A 59-year-old male presented with a subacute/chronically dislocated CMC joint of the thumb. Open reduction with pin fixation and dorsoradial ligament repair and augmentation was chosen to restore the stability of the joint. Joint reduction without subluxation was successfully maintained. By 12 weeks postoperatively, there were no remaining major restrictions to activity.Repair of the dorsoradial ligament with augmentation and pinning is a viable approach for surgical management of subacute/chronic dislocation of the thumb CMC joint.

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Management of Acute and Chronic Thumb CMC Joint Dislocations

Weeks

Donato

2022

Hand Clinics

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Postoperative Therapy for Chronic Thumb Carpometacarpal (CMC) Joint Dislocation

Cited by 4 publications

References 7 publications

Thumb metacarpal dislocation after trapeziectomy with ligamentous reconstruction and tendon interposition: A case report

Thumb metacarpal dislocation after trapeziectomy with ligamentous reconstruction and tendon interposition: A case report

Chronic Dislocation of the Thumb Carpometacarpal Joint: A Case Report

Management of Acute and Chronic Thumb CMC Joint Dislocations

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