Pure isolated dorsal dislocation of the fifth carpometacarpal joint

Abstract

Isolated pure dislocations of the fifth carpo-metacarpal joint are extremely rare injuries. The dorsal form was described in mere 12 cases. The diagnosis can be easily missed. The lesion is also often overlooked in the routine diagnostic X-ray. Lateral and oblique views are important for the recognition of the true extent of the lesion. Treatment of these injures is still controversial and both closed reduction with percutaneous pinning or open reduction with internal fixation are advocated. The goal of treatment is early reduction and fixation of the metacarpal. Early diagnosis is the key to success. The aim of this paper is to review literature and present two new cases.

Dislocation of the Hamatometacarpal Joint: About a Rare Case

“…[2] Its treatment is still controversial. [1] However, a reduced dislocation which remained stable could be treated conservatively whereas in the case of an unstable dislocation, as in our case, or delay in diagnosis or presentation, it becomes imperative to use k-wires for fixation after closed/open reduction. [7] On the other hand, some authors recommend a surgical fixation as a definitive treatment choice because close reduction alone is insufficient to maintain adequate stability.…”

“…Pure isolated dislocation of the fifth carpometacarpal joint is extremely rare. [1] Given its rarity and its subtle abnormalities on standard radiograph it is frequently missed on the first examination which constitutes a real challenging diagnosis. When left untreated, these injuries can lead to chronic pain, stiffness and posttraumatic arthritis.…”

Conservative Treatment of Isolated Dorsal Dislocations of Fourth and Fifth Carpometacarpal Joints: A Report of a Rare Case

“…However, in the literature there have been reported cases of missed or delayed diagnoses, especially in patients with other obvious injuries, or when there are existing fractures in carpal/hand bones or extended diffuse hand swelling obscuring joint deformity that might mislead the clinicians, or even due to technically insufficient initial radiographs [7][8][9][10].…”

“…However, many authors advocate open reduction and internal fixation or closed reduction and percutaneous pinning to restore and maintain an anatomic reduction, and to prevent secondary dislocation [11,13]. Although there are no studies with a remarkable number of patients to extract safe conclusions for the treatment of these disorders, it is strongly recommended that in cases of associated fractures, delayed diagnosis, and insufficient or failed closed reduction, surgical intervention is the best management [4,7,8,[10][11][12]14,[16][17][18].…”

A comparative study on the clinical efficacy of microplate trans-carpometacarpal joint fixation and non-trans-carpometacarpal joint fixation in treating fractures with dislocation or subluxation of the base of the fourth and fifth metacarpal bones

“…Some scholars used Kirschner wires to fix basal fractures and dislocations of the 4th and 5th metacarpal bones, such as Valente et al [ 24 ] who believed that closed reduction and percutaneous Kirschner wire internal fixation technique was the most effective method for treating basal fractures and dislocations of the 4th and 5th metacarpal bones; Schortinghuis et al [ 7 ] believed that using open reduction and internal fixation technique to treat unstable 4th and 5th metacarpal basal fractures and dislocations could also achieve good results. We believe that the open reduction and internal fixation technique was more difficult than the Kirschner wire fixation technique and requires experienced physicians to perform the operation.…”