Carpometacarpal fracture-dislocations: a retrospective review of injury characteristics and radiographic outcomes

Review written by Ian Gatt info

Key Points

  1. Delivering a blow with a closed fist was the most common mechanism of injury.
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BACKGROUND & OBJECTIVE

Carpometacarpal (CMC) dislocation and fracture-dislocations account for <1% of all hand injuries in the general population (1) and 6.8 to 21.6% of hand injuries in sports (2,3). Commonly, the mechanism of CMC joint injuries involves a traumatic, high energy episode affecting tendon, ligament and/or bone structures. In boxing, Noble et al (4) stated that if hyperflexion of the wrist occurred on impact, it would injure the CMC joint of the hand (see Figure 1).

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Management of these injuries aims at ensuring anatomical reduction (see Figure 2) and return to normal function. Commonly described treatment options for these injuries include closed reduction and casting, closed reduction and percutaneous pinning, and open reduction and internal fixation.

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This retrospective review aimed to document the demographics and early radiographic outcomes of a large series of patients with CMC injuries over a 10-year period.

Carpometacarpal injuries account for 6.8 to 21.6% of hand injuries in sports.
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Early diagnosis of CMC joint injuries is an important factor to ensure optimal management.

METHODS

Only patients who sustained CMC dislocations and fracture-dislocations of digits 2 to 5 were included in this study. Patients with thumb trapeziometacarpal joint injuries were excluded. 80 patients, with 81 involved hands, were included. Five patients with six injured hands

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