A Case study on the Treatment of Severe Displacement of the Thumb Carpometacarpal Joints
DOI:
https://doi.org/10.56294/hl2025599Keywords:
Spinal Dural Arteriovenous Fistula (SDAVF), Medical Records, Radiograph, Surgical Repair, Fluorescence AngiographyAbstract
Severe disability might result from a chronic carpometacarpal (CMC) dislocation. Displacement of the pollex's CMC joint is a rather rare damage. The anterior oblique ligament (AOL) has historically been the focus of surgical surgery, but more lately, the dorsoradial ligament (DRL) has drawn greater attention. Both ligaments must be considered to get the optimum functional outcomes during CMC joint rehabilitation. The purpose of this research was to examine the treatment of a case with severe dislocation of the thumb CMC joints. Case report: Following a motorbike accident, a 34-year-old man came with acute discomfort in his left hand. The diagnosis is that the man had many second to fifth CMC joint fracture-dislocations. Under general anesthesia, man had successful closure reduction and numerous Kirshner wire (K-wire) fixation. Excellent clinical outcomes tore verified after a one-year follow-up. Nonetheless, it includes the proportion of patient average mean value, loss of reduction, DASH score, Numeric rating scale (NSR), grip strength. For all dislocations of the CMC joint, it is advisable to use the closed reduction. To get a stable fixation and fantastic outcomes, K-wire fixation maybe incorporated. Acute or subacute thumb CMC joint displacement may be cured by fixing the dorsoradial muscle and anchoring it. Rarely do CMC fracture-dislocations include several bones. For a precise diagnosis, simple radiography and clinical exams are required. It is common practice to treat fractures and dislocations. Successful in the instance was a straightforward closed reduction with K-wires repair.
References
1. Milks K, Warren P, Popp J, Samora JB. Feasibility of Ultrasound in Infant Wrist and Thumb Imaging. Journal of Ultrasound in Medicine. 2019 Jun;38(6):1561-6. https://doi.org/10.1002/jum.14845
2. Kim JS, Hussain K, Higginbotham DO, Tsai AG. Management of thumb carpometacarpal joint dislocations: A systematic review. Journal of Orthopaedics. 2021 May 1;25:59-63. https://doi.org/10.1016/j.jor.2021.03.015
3. Jerome JT. Arthrodesis for habitual dorsal dislocation of the thumb metacarpophalangeal joint-A case report. Journal of Orthopaedic Reports. 2023 Jun 1;2(2):100134. https://doi.org/10.1016/j.jorep.2023.100134
4. Bhardwaj P, Sivakumar BS, Vallurupalli A, Pai M, Sabapathy SR. Fracture dislocations of the carpometacarpal joints of the fingers. Journal of clinical orthopaedics and trauma. 2020 Jul 1;11(4):562-9. https://doi.org/10.1016/j.jcot.2020.05.039
5. Stauffer A, Schwarz Y, Uranyi M, Schachinger F, Girsch W, Ganger R, Farr S. Outcomes after thumb carpometacarpal joint stabilization with an abductor pollicis longus tendon strip for the treatment of chronic instability. Archives of Orthopaedic and Trauma Surgery. 2020 Feb;140:275-82. https://doi.org/10.1007/s00402-019-03302-8
6. Kastanis G, Pantouvaki A, Trachanatzi E, Stavrakakis I, Chaniotakis C, Siligardou MK, Kapsetakis P. Acute Traumatic Isolated Subluxation of Trapeziometacarpal Joint: Case Report-Literature. International Journal of Innovative Research in Medical Science (IJIRMS). 2022 Oct;7(10). https://doi.org/10.23958/ijirms/vol07-i10/1510.
7. Jason MI, Muramatsu K, Tani Y, Kobayashi M. Atypical erosive tophaceous gout with severe osteolysis around multiple joints of the digits: A case report. Journal of Orthopaedic Reports. 2022 Dec 1;1(4):100101. https://doi.org/10.1016/j.jorep.2022.100101
8. Knoedler TG, Condit KM, Zachary SV. Recurrent bilateral basilar joint subluxation in a teenage boy. Journal of Hand Surgery Global Online. 2021 Nov 1;3(6):363-7. https://doi.org/10.1016/j.jhsg.2021.07.001
9. Ahn KS, Choi IC, Kang CH, Park JW. Ultrasound diagnosis and follow-up of a locked thumb metacarpophalangeal joint caused by radial sesamoid entrapment: a case report. BMC Musculoskeletal Disorders. 2020 Dec;21:1-5. https://doi.org/10.1186/s12891-020-03541-6
10. Halverson JC, Cornelson SM, Murray QW, Kettner NW. Baseball Injury Resulting in Type III Salter-Harris Fracture of the First Proximal Phalangeal Base: A Case Report. Journal of Chiropractic Medicine. 2021 Dec 1;20(4):218-23. https://doi.org/10.1016/j.jcm.2021.12.006
11. Rashidi A, Haj-Mirzaian A, Dalili D, Fritz B, Fritz J. Evidence-based use of clinical examination, ultrasonography, and MRI for diagnosing ulnar collateral ligament tears of the metacarpophalangeal joint of the thumb: systematic review and meta-analysis. European Radiology. 2021 Aug;31:5699-712. https://doi.org/10.1007/s00330-020-07666-z
12. Eda Y, Totoki Y, Nakagawa T, Yamazaki M. A case report of comminuted trapezium fracture with surgical treatment. Trauma Case Reports. 2022 Dec 1;42:100732. https://doi.org/10.1016/j.tcr.2022.100732
13. Kastenberger T, Kaiser P, Schmidle G, Stock K, Benedikt S, Arora R. Clinical results of the BoneTolding® Fiji® anchor for the treatment of Stener lesions of the thumb. Archives of Orthopaedic and Trauma Surgery. 2021 Sep;141:1499-507. https://doi.org/10.1007/s00402-020-03625-x
14. Chaves C, Dubert T. Ulnar-sided carpometacarpal fractures and fractures-dislocations. A systematic review and publication guidelines. Orthopaedics & Traumatology: Surgery & Research. 2020 Dec 1;106(8):1637-43. https://doi.org/10.1016/j.otsr.2020.03.039
15. Bueno BT, Smith TA, Lotito MJ, Phelan JV, Epstein RE, Katt BM, Kirschenbaum D, Smith T, Lotito M. Successful Non-operative Management of Metacarpophalangeal Collateral Ligament and Sagittal Band Rupture of the Long Finger: A Case Report. Cureus. 2022 Jun 23;14(6). DOI 10.7759/cureus.26231
16. Nakayama M, Sakuma Y, Tobimatsu H. Recurrent volar dislocation of the metacarpophalangeal joint of the thumb with radial collateral ligament injury: a case report. International Journal of Surgery Case Reports. 2020 Jan 1;68:96-9. https://doi.org/10.1016/j.ijscr.2020.01.056
17. Montanari S, Pangallo L, Valore A, Adani R. Palmar fracture-dislocation of the trapezoid with median nerve contusion. Case report and literature review. Case Reports in Plastic Surgery and Hand Surgery. 2021 Jan 1;8(1):76-80. https://doi.org/10.1080/23320885.2021.1927739
18. Bouvet C, Davat M, Mauler F, Beaulieu JY. Costal cartilage graft for an unstable post-traumatic trapeziometacarpal intra-articular malunion in a pediatric patient: A case report. Hand Surgery and Rehabilitation. 2021 Apr 1;40(2):198-201. https://doi.org/10.1016/j.hansur.2020.10.014
19. Komura S, Hirakawa A, Ishizuka K, Matsushita Y, Akiyama H. Mini hook plate fixation for thumb ulnar collateral ligament avulsion fracture: A technical report. Orthopaedics & Traumatology: Surgery & Research. 2019 May 1;105(3):429-33. https://doi.org/10.1016/j.otsr.2019.01.008
20. Elghoul N, Bouya A, Jalal Y, Zaddoug O, Benchakroun M, Jaafar A. Complex metacarpophalangeal joint dislocation of the litter finger: A sesamoid bone seen within joint. What does it mean?. Trauma Case Reports. 2019 Oct 1;23:100225. https://doi.org/10.1016/j.tcr.2019.100225
21. Carroll JJ, McClain WD, Nuelle JA. Treatment of a subacute locked thumb metacarpophalangeal joint with sesamoid entrapment. Case Reports in Orthopedics. 2019;2019(1):2136540. https://doi.org/10.1155/2019/2136540
22. Qudsi RA, Moontasri NJ, Ty JM. Thumb Metacarpal Base Fracture. Pediatric Orthopedic Trauma Case Atlas. 2020:307-14. https://doi.org/10.1007/978-3-319-29980-8_45
23. Wu GJ, Loetonstein SN, Adkinson JM. Side-to-side metacarpal fusion for reconstruction of bone loss in the radial carpometacarpal joints. Journal of Hand Surgery Global Online. 2021 Sep 1;3(5):298-301. https://doi.org/10.1016/j.jhsg.2021.06.009
24. Poggi DS, Massarella M, Piccirilli E. The treatment of chronic ulnar collateral ligament of the thumb injury using extensor pollicis brevis: Surgical technique. Journal of Hand Surgery Global Online. 2021 Jan 1;3(1):56-60. https://doi.org/10.1016/j.jhsg.2020.10.002
25. Suwannaphisit S, Suwanno P, Fongsri W, Wongsiri S. Multiple carpometacarpal joint fracture-dislocation from the second to fifth: a case report. Annals of Medicine and Surgery. 2022 Apr 1;76. DOI: 10.1016/j.amsu.2022.103596
26. Roux JL. Double Oblique Osteotomy and Rotation of the trapeziometacarpal Joint (DOOR procedure). Hand Surgery and Rehabilitation. 2021 Sep 1;40:S53-61. https://doi.org/10.1016/j.hansur.2020.09.012
27. Zaizi A, El Yaacoubi T, El Bahraouy A, Zamani O, Boukhris J, Bouabid S, Boussouga M. Pure divergent dislocation of the index and middle finger carpometacarpal joints: A rare case. Trauma Case Reports. 2019 Oct 1;23:100222. https://doi.org/10.1016/j.tcr.2019.100222
28. Giotis D, Paschos NK, Plakoutsis S, Vardakas D, Konstantinidis C, Plakoutsis SK, VARDAKAS DG. Conservative treatment of isolated dorsal dislocations of fourth and fifth carpometacarpal joints: A report of a rare case. Cureus. 2023 Feb 23;15(2). DOI 10.7759/cureus.35356
29. Poirot-Seynaeve B, Joseph E, Diaz JJ, Nerot C, Zran N. Delayed open reduction and fixation of an isolated trapezium dislocation. Journal of Hand Surgery Global Online. 2022 Jan 1;4(1):57-60. https://doi.org/10.1016/j.jhsg.2021.08.006
30. Borgers A, Verstreken A, Vanhees M, Verstreken F. Primary endoprosthetic replacement of the arthritic CMC-1 joint. Operative Orthopädie und Traumatologie. 2021 Jun;33(3):228-44. https://doi.org/10.1007/s00064-021-00713-y.
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Copyright (c) 2025 Vundela Swathi, Aniruddh Dash , Chandana Majhee, Prerak Sudan , V.A Satre , B. Reddy (Author)
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