Management of thumb carpometacarpal joint dislocations: A systematic review

Kim, Jennifer; Hussain, Kumail; Higginbotham, Devan O.; Tsai, Andrew G.

doi:10.1016/j.jor.2021.03.015

Cited by 8 publications

(12 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[22,23] Although atypical in presentation, this patient was successfully managed with a standard treatment of percutaneous pinning and splint immobilization. [24,25] Unlike many cases of primary dislocation which variably require ligament reconstruction, our patient had already gone ligament reconstruction as an element of the index operation, and this was found to be intact. Wollstein et al described the case of a chronic, recurrent thumb CMC dislocation treated with trapeziectomy and a modified LRTI.…”

Section: Discussionmentioning

confidence: 80%

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

Weber

Frankenhoff²

2022

CSS

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 80%

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

Weber

Frankenhoff²

2022

CSS

View full text Add to dashboard Cite

show abstract

“…Stauffer et al (2020) used as tendon graft APL and reported in 15 operated thumbs that postoperative grip, pinch strength, and passive stability were not significantly different between operated and non-operated sides while Mean DASH score was 13.3 and VAS 1,1 [31] . Kim et al (2021) in a systematic review 85% report that most common tendon graft which utilize was FCR (57%) following by APL (29%) and all studies with this two methods prove normal range of motion without posttraumatic instability sustainment the effectiveness of the two methods [16] .…”

Section: Discussionmentioning

confidence: 99%

“…Obert et al (1997) with the same procedure in 7 with a mean follow-up eight year postinjury cases reported satisfactory outcomes without instability or degenerative change of the joint [28] . Trapeziometacarpal joint dislocation affected the capsuloligamentous complex of the thumb and must be treated as ligamentous injury, so percutaneous pinning must be accompanied by reconstruction of ligaments [16] . Shah et al (1983) suggest that closed reduction of TMCJ dislocation has unstable results and open reduction and ligament reconstruction with tendon graft is efficacy treatment [23] .…”

Section: Discussionmentioning

confidence: 99%

“…McCarthy et al (2014) suggest an algorithm to treat the acute TMCJ dislocation or subluxation started with closed reduction and radiographic control of instability. If subluxation persisted, repair of dorsolateral ligament was performed by using suture anchors with pinning the joint and cast immobilization for 6 weeks [16] . The advantage of repair of DRL is the most important stabilizer of trapeziometacarpal joint [16] .…”

Section: Discussionmentioning

confidence: 99%

“…If subluxation persisted, repair of dorsolateral ligament was performed by using suture anchors with pinning the joint and cast immobilization for 6 weeks [16] . The advantage of repair of DRL is the most important stabilizer of trapeziometacarpal joint [16] . In our case we follow this algorithm and we repair the DRL with end-to-end suture.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Acute Traumatic Isolated Subluxation of Trapeziometacarpal Joint: Case Report-Literature Review

Kastanis

Pantouvaki

et al. 2022

ijirms

View full text Add to dashboard Cite

Trapeziometacarpal joint (TMCJ) of the thumb is an unstable joint anatomically and depends on the integrity and normal functionality of the ligaments to prevent dislocation. Dislocation or subluxation of trapezio-metacarpal joint generally appears more often as injuries accompanied with intraarticular fracture of base of first metacarpal or trapezium. Isolated dorsolateral subluxation of trapeziometacarpal joint appears more often with osteoarthritis of the joint rather than as traumatic lesion and is an unstable injury because ligaments of the joint present some degree of impairment. Suspicions to diagnose the injury and precocious therapeutic management avoid complications which lead to impairment of hand function quality. Therapeutic procedures for TMCJ dislocation is controversial in literature. The aim of this study is to present a case of a 28 year-old man, who after a direct impact with a heavy object (hummer) over the base of the thumb, presented in the emergency department with an anterolateral subluxation of trapeziometacarpal joint and based on this case, to recall the modalities of the adequate treatment of the respective injury in literature.

show abstract

Management of thumb carpometacarpal joint dislocations: A systematic review

Cited by 8 publications

References 33 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

Acute Traumatic Isolated Subluxation of Trapeziometacarpal Joint: Case Report-Literature Review

Simultaneous quadruple dislocations of the hand in a motorcyclist: A case report

Contact Info

Product

Resources

About