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Carpometacarpal Joint Dislocation

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Other Names

  • Thumb CMC Dislocation
  • Thumb Carpometacarpal Joint Dislocation

Background

History

Epidemiology

  • Account for less than 1% of hand injuries
  • More common in dominant hand
  • More often multiple dislocations rather than single isolated[1]
  • 50% involve 5th MCPJ, 25% 2nd MCPJ[2]

Pathophysiology

  • Mechanism
    • Punching
    • Fall
    • Thumb: axial load on flexed thumb or dorsal force applied to 1st webspace
  • Associated injuries

Risk Factors

  • Young males

Differential Diagnosis


Clinical Features

  • General: Physical Exam Wrist
  • Patients will report swelling, pain at affected joint(s)
  • Deformity may or may not be obvious depending on degree of swelling
  • Inability to form a fist

Evaluation

Radiographs

CT

MRI

  • Recurrent instability after reduction, evaluate soft tissue injuries

Classification

  • N/A

Management

Nonoperative

Operative

  • Thumb Indications
    • Unstable joint

Return to Play

  • Highly variable

Complications

  • Persistent pain
  • Joint instability or stiffness
  • Posttraumatic arthritis

See Also


References


  1. Lefere, M., et al. "Rare carpometacarpal dislocations." Orthopaedics & Traumatology: Surgery & Research 102.6 (2016): 813-816.
  2. Fisher, Madeleine R., Lee F. Rogers, and Ronald W. Hendrix. "A systematic approach to the diagnosis of carpometacarpal dislocations." RadioGraphics 2.4 (1982): 612-627.
Created by:
John Kiel on 30 September 2019 13:22:50
Authors:
Last edited:
28 October 2020 13:45:02
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