Volar Dislocation of Multiple Carpometacarpal Joints: Report of Four Cases

Abstract

Four acute cases of volar carpometacarpal dislocations of the medial four metacarpals were treated in our hospital's emergency room. Our initial diagnosis after clinical examination was confirmed by routine x-rays of the hand. Closed reduction was followed by percutaneous fixation of the carpometacarpal joints with Kirschner wires. Satisfactory function of the hand was obtained in all cases.

Volar dislocation of four carpometacarpal joint: A rarest injury

“…Only two reports of isolated volar index finger CMC dislocations 8,9 and two reports of volar CMC dislocations of the index and long fingers 2,10 are mentioned in literature. Volar CMC dislocations of the four ulnar metacarpals are reported by three authors 4,11,12 . In our case report not only volar dislocation of all four CMC joints but two CMC joints were dislocated towards radial side and two towards ulnar side which is a very rare occurence.…”

Multiple Carpometacarpal Dislocations of the Hand – An Uncommon Variant: A Rare Case

“…7) Kumar and Malhotra 8) and Kumar et al 9) described a "divergent variant" of multiple CMC joint dislocations in which divergence is defined as a volar dislocation of ≥ 1 joint with concomitant dorsal dislocation of ≥ 1 joint. In our patient, the most likely mechanism of injury would appear to be a fall on the dorsum of hand with direct force applied to the bases of metacarpals.…”

“…An overlap on the lateral X-ray may obscure the accurate depiction of the injury pattern, and most authors recommend at least one variant of an oblique view for making a diagnosis of carpometacarpal fracture dislocations. 9) Computed tomography (CT) is used to diagnose occult or missed carpal bone fractures. A CT Scan is often helpful in classifying the injury and planning the treatment in complex pattern injuries 11) and it was done in our case.…”

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

“…There are two reports of isolated volar index finger CMC dislocations [25,26], as well as two reports of volar CMC dislocations of the index and long fingers [1,14]. Three authors report volar CMC dislocations of the four ulnar metacarpals [4,17,19], while there is one report of divergent CMC volar dislocations between the second CMC and the three ulnar CMC joints [18]. We report the rare case of isolated volar CMC dislocations of the ring and small fingers treated with open reduction and internal fixation.…”