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Volar Dislocation of the Fourth and Fifth Carpometacarpal Joints: A Case Report and Review of the Literature

  • Case Report
  • Published:
HSS Journal

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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References

  1. Weiland AJ, Lister GD, Villareal-Rios A (1976) Volar fracture dislocations of the second and third carpometacarpal joints associated with acute carpal tunnel syndrome. J Trauma 16:672–675

    Article  PubMed  CAS  Google Scholar 

  2. McWhorter GL (1918) Isolated and complete dislocation of the fifth carpometacarpal joint: open operation. Surg Clin Chicago 2:793–796

    Google Scholar 

  3. Nalebuff EA (1968) Isolated anterior carpometacarpal dislocation of the fifth finger: classification and case report. J Trauma 8:1119–1123 doi:10.1097/00005373-196811000-00017

    PubMed  CAS  Google Scholar 

  4. Bajekal RA, Kotwal PP, Menon D (1992) Closed volar dislocations of the four ulnar carpometacarpal joints. Injury 23:355–356 doi:10.1016/0020-1383(92)90197-Z

    Article  PubMed  CAS  Google Scholar 

  5. Berg EE, Murphy DF (1986) Ulnopalmar dislocation of the fifth carpometacarpal joint—successful closed reduction: review of the literature and anatomic reevaluation. J Hand Surg 11A:521–525

    Google Scholar 

  6. Buzby BF (1934) Palmar carpo-metacarpal dislocation of the fifth metacarpal. Ann Surg 100:555–557 doi:10.1097/00000658-193409000-00022

    Article  Google Scholar 

  7. Chen VT (1987) Dislocation of carpometacarpal joint of the little finger. J Hand Surg 12B:260–263

    Google Scholar 

  8. Dennyson WG, Stother IG (1976) Carpometacarpal dislocation of the little finger. Hand 8:161–164 doi:10.1016/0072-968X(76)90040-1

    Article  PubMed  CAS  Google Scholar 

  9. Fernyhough J, Trumble T (1990) Late posttraumatic carpometacarpal dislocation of the ring and little finger. J Orthop Trauma 4:200–203 doi:10.1097/00005131-199004020-00019

    Article  PubMed  CAS  Google Scholar 

  10. Fischer JW, Waseem M, Gambhir A, Creedon RJ (2002) Ulnopalmar dislocation of the fifth carpometacarpal joint: a rare injury. Acta Orthop Belg 68:175–177

    PubMed  CAS  Google Scholar 

  11. Gore DR (1971) Carpometacarpal dislocation producing compression of the deep branch of the ulnar nerve. J Bone Jt Surg 53A:1387–1390

    Google Scholar 

  12. Gunther SF, Bruno PD (1985) Divergent dislocation of the carpometacarpal joint: a case report. J Hand Surg 10A:197–201

    Google Scholar 

  13. Hartwig RH, Louis DS (1979) Multiple carpometacarpal dislocations: a review of four cases. J Bone Jt Surg 61A:906–908

    Google Scholar 

  14. Harwin SF, Fox JM, Sedlin ED (1975) Volar dislocation of the bases of the second and third metacarpals. J Bone Jt Surg 57A:849–851

    Google Scholar 

  15. Hazlett JW (1968) Carpometacarpal dislocations other than the thumb: a report of eleven cases. Can J Surg 11:315–323

    PubMed  CAS  Google Scholar 

  16. Ker HR (1955) Dislocation of the fifth carpo-metacarpal joint. J Bone Jt Surg 37B:254–256

    Google Scholar 

  17. Kleinman WB, Grantham SA (1978) Multiple volar carpometacarpal joint dislocation: case report of traumatic volar dislocation of the medial four carpometacarpal joints in a child and review of the literature. J Hand Surg 3A:377–382

    Google Scholar 

  18. Kumar R, Malhoutra R (2001) Divergent fracture-dislocation of the second carpometacarpal joint and the three ulnar carpometacarpal joints. J Hand Surg 26A:123–129

    Google Scholar 

  19. Kumar S, Arora A, Jain AK, Agarwal A (1998) Volar dislocation of multiple carpometacarpal joints: report of four cases. J Orthop Trauma 12:523–526 doi:10.1097/00005131-199809000-00019

    Article  PubMed  CAS  Google Scholar 

  20. Lintner SA, Rettig AC (1995) Isolated volar carpometacarpal dislocation of the fifth digit. Am J Orthop 24:918–919

    PubMed  CAS  Google Scholar 

  21. Mehara AK, Bhan S (1993) Rotatory dislocation of the second carpometacarpal joint: case report. J Trauma 34:464–466 doi:10.1097/00005373-199303000-00032

    PubMed  CAS  Google Scholar 

  22. North ER, Eaton RG (1980) Volar dislocation of the fifth metacarpal: report of two cases. J Bone Jt Surg 62A:657–659

    Google Scholar 

  23. O’Rourke PJ, Quinlan W (1993) Fracture dislocation of the fifth metacarpal resulting in compression of the deep branch of the ulnar nerve. J Hand Surg 18B:190–191

    Google Scholar 

  24. Roberts N, Holland CT (1936) Isolated dislocation of the base of the fifth metacarpal. Br J Surg 23:567–571 doi:10.1002/bjs.1800239110

    Article  Google Scholar 

  25. Schutt RC, Boswick JA, Scott FA (1981) Volar fracture-dislocation of the carpometacarpal joint of the index finger treated by delayed open reduction. J Trauma 21:986 doi:10.1097/00005373-198111000-00015

    Article  PubMed  Google Scholar 

  26. Thomas WO, Gottliebson WM, D’Amore TF, Parry SW (1994) Isolated palmar displaced fracture of the base of the index metacarpal: a case report. J Hand Surg 19A:455–456

    Google Scholar 

  27. Tountas AA, Kwok JMK (1984) Isolated volar dislocation of the fifth carpometacarpal joint: a case report. Clin Ortop 187:172–175

    Google Scholar 

  28. Woo CC (1988) Traumatic volar dislocation of the second, third, and fourth carpometacarpal joints: mechanism and manipulation. J Manip Physiol Ther 11:124–129

    CAS  Google Scholar 

  29. Hsu JD, Curtis RM (1970) Carpometacarpal dislocations on the ulnar side of the hand. J Bone Jt Surg 52A:927–930

    Google Scholar 

  30. Henderson JJ, Arafa MAM (1987) Carpometacarpal dislocation: an easily missed diagnosis. J Bone Jt Surg 69B:212–214

    Google Scholar 

  31. Waugh RL, Yancey AG (1948) Carpometacarpal dislocations. J Bone Jt Surg 30A:397–404

    CAS  Google Scholar 

  32. Peterson P, Sacks S (1986) Fracture-dislocation of the base of the fifth metacarpal associated with injury to the deep motor branch of the ulnar nerve: a case report. J Hand Surg 11A:525–528

    Google Scholar 

  33. Young TB (1987) Dorsal dislocation of the metacarpal base of the little and ring fingers with ulnar nerve compression. Injury 18:65–73 doi:10.1016/0020-1383(87)90392-5

    Article  PubMed  CAS  Google Scholar 

  34. Glickel SZ, Barron OA, Eaton RG (1999) Dislocations and ligament injuries in the digits. In: Green DP (ed) Operative hand surgery, 4th edn. Churchill Livingstone, New York, p 786

    Google Scholar 

  35. Bora FW, Didizian NH (1974) The treatment of injuries to the carpometacarpal joint of the little finger. J Bone Jt Surg 56A:1459–1463

    Google Scholar 

  36. Fisher MR, Rogers LF, Hendrix RW (1983) Systematic approach to identifying fourth and fifth carpometacarpal joint dislocations. Am J Roentgenol 140:319–324

    CAS  Google Scholar 

  37. Fisher MR, Rogers LF, Hendrix RW, Gilula LA (1984) Carpometacarpal dislocations. Crit Rev Diagn Imaging 22:95–126

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Hand and Upper Extremity Surgery, The Hospital for Special Surgery, New York, NY, USA

    Peter M. Prokopis MD & Andrew J. Weiland MD

  2. Sports Medicine North, One Orthopedics Drive, Peabody, MA, 01960, USA

    Peter M. Prokopis MD

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  1. Peter M. Prokopis MD
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  2. Andrew J. Weiland MD
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Correspondence to Andrew J. Weiland MD.

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Prokopis, P.M., Weiland, A.J. Volar Dislocation of the Fourth and Fifth Carpometacarpal Joints: A Case Report and Review of the Literature. HSS Jrnl 4, 138–142 (2008). https://doi.org/10.1007/s11420-008-9086-3

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  • DOI: https://doi.org/10.1007/s11420-008-9086-3

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