Pure divergent dislocation of the index and middle finger carpometacarpal joints: A rare case

Abstract

A pure divergent dislocation involving the index and middle finger carpometacarpal joints is an extremely rare injury. We present a case of 21-year-old military man, victim of a motor vehicle accident, admitted at the emergency department unable to move his left hand with major swelling. X-rays and CT scan showed a dorsal dislocation of second and palmar dislocation of the third carpometacarpal joints without associated fracture, In the Operating room under general anesthesia, patient underwent closed reduction and internal fixation with percutaneous K-Wires followed by cast immobilization during 6 weeks. Physiotherapy was started progressively after k-wires removal. At two months follow-up, results were excellent and patient has recovered all of his range of motion and hand activities, at one-year follow-up he was able to perform all military exercises such as pumping and climbing.

Reconhecimento precoce e tratamento das fraturas e luxações carpometacarpais

“…The dislocation of the 2 nd and 3 rd CMC, volar or dorsal, has been reported in the literature. 14 Zaizi et al 15 published a case of divergent dislocation, in which the 3 rd CMC moved to volar, and the 2 nd CMC dislocated to the dorsal region. Mane et al 16 showed an undiagnosed lesion in a patient who had volar dislocation of the five carpometacarpal joints.…”

“…A luxação do 2° e 3° MTC, volar ou dorsal, tem sido relatada na literatura. 14 Zaizi et al 15 publicaram um caso de luxação divergente, em que o 3° MTC deslocou-se para volar e o 2° MTC luxou para a região dorsal. Mane et al 16 mostraram uma lesão não diagnosticada numa paciente que teve luxação volar das cinco articulações CMCs.…”

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“…A luxação do 2°e 3°MTC, volar ou dorsal, tem sido relatada na literatura. 14 Zaizi et al 15 publicaram um caso de luxação divergente, em que o 3°MTC deslocou-se para volar e o 2°M TC luxou para a região dorsal. Mane et al 16 mostraram uma lesão não diagnosticada numa paciente que teve luxação volar das cinco articulações CMCs.…”

Conservative Management of the Ring and Little Finger Carpometacarpal Joint Dorsal Dislocations

“…Treatment is determined by the severity of the dislocation, stability of the CMC joints, and the time of hand injury management. Closed reduction is usually possible when the dislocation is recent, whereas open reduction is required for dislocations more than 15 days old [ 4 ].…”