Top

Published in:

Open Access 01-12-2023 | Computed Tomography | Case report

Bennett fracture combined with hamate fracture: carpometacarpal joint ‘diagonal’ fracture and dislocation: a case report

Authors: Wei-Bin Wu, Yun-Feng Du, Hong-Xing Wang, Feng Liang

Published in: BMC Musculoskeletal Disorders | Issue 1/2023

Abstract

Background

Multiple carpometacarpal fractures and dislocations are rare. This case report describes a novel multiple carpometacarpal injury, namely, ‘diagonal’ carpometacarpal joint fracture and dislocation.

Case presentation

A 39-year-old male general worker sustained a compression injury to his right hand in the dorsiflexion position. Radiography indicated a Bennett fracture, hamate fracture, and fracture at the base of the second metacarpal. Subsequent computed tomography and intraoperative examination confirmed an injury to the first to fourth carpometacarpal joint along a diagonal line. The normal anatomy of the patient’s hand was successfully restored via open reduction combined with Kirschner wire and steel plate fixation.

Conclusion

Our findings highlight the importance of taking the injury mechanism into account to avoid a missed diagnosis and to choose the best treatment approach. This is the first case of ‘diagonal’ carpometacarpal joint fracture and dislocation to be reported in the literature.

Anwar SF. Divergent carpometacarpal fracture dislocation. J Coll Physicians Surg Pak. 2013;23(4):301–2.

Woon CYL, Chong KC, Low CO. Carpometacarpal joint dislocations of the index to small finger: three cases and a review of the literature. In J Extra. 2006;37:466–72. https://doi.org/10.1016/j.injury.2006.06.109.CrossRef

Pankaj A, Malhotra R, Bhan S. Isolated dislocation of the four ulnar carpometacarpal joints. Arch Orthop Trauma Surg. 2005;125:541–4. https://doi.org/10.1007/s00402-005-0829-z.CrossRefPubMed

Kneife F. Simultaneous dislocations of the five carpometacarpal joints. Injury. 2002;33:846. https://doi.org/10.1016/s0020-1383(02)00098-0.CrossRefPubMed

Dzwierzynski WW, Matloub HS, Yan JG, Deng S, Sanger JR, Yousif NJ. Anatomy of the intermetacarpal ligaments of the carpometacarpal joints of the fingers. J Hand Surg Am. 1997;22:931–4. https://doi.org/10.1016/S0363-5023(97)80093-7.CrossRefPubMed

Nanno M, Buford WL Jr, Patterson RM, Andersen CR, Viegas SF. Three-dimensional analysis of the ligamentous attachments of the second through fifth carpometacarpal joints. Clin Anat. 2007;20:530–44. https://doi.org/10.1002/ca.20426.CrossRefPubMed

Hartwig RH, Louis DS. Multiple carpometacarpal dislocations. A review of four cases. J Bone Joint Surg Am. 1979;61:906–8. https://doi.org/10.2106/00004623-197961060-00018.CrossRefPubMed

De Beer JDV, Maloon S, Anderson P, Jones G, Singer M. Multiple carpo-metacarpal dislocations. J Hand Surg. 1989;14:105–8. https://doi.org/10.1016/0266-7681(89)90028-4.CrossRef

Lawlis JF III, Gunther SF. Carpometacarpal dislocations. Long-term follow-up. J Bone Joint Surg Am. 1991;73:52–9. https://doi.org/10.2106/00004623-199173010-00007.CrossRefPubMed

10.

Pundkare GT, Patil AM. Carpometacarpal joint fracture dislocation of second to fifth finger. Clin Orthop Surg. 2015;7:430–5. https://doi.org/10.4055/cios.2015.7.4.430.CrossRefPubMedPubMedCentral

11.

Zhang C, Wang H, Liang C, Yu W, Li Y, Shang R, et al. The effect of timing on the treatment and outcome of combined fourth and fifth carpometacarpal fracture dislocations. J Hand Surg Am. 2015;40:2169–2175e1. https://doi.org/10.1016/j.jhsa.2015.07.017.CrossRefPubMed

12.

Bao B, Zhu H, Zheng X. Plate versus Kirschner wire fixation in treatment of fourth and fifth carpometacarpal fracture-dislocations: a retrospective cohort study. Int J Surg. 2018;52:293–6. https://doi.org/10.1016/j.ijsu.2018.01.052.CrossRefPubMed

13.

Wharton DM, Casaletto JA, Choa R, Brown DJ. Outcome following coronal fractures of the hamate. J Hand Surg Eur Vol. 2010;35:146–9. https://doi.org/10.1177/1753193408098907.CrossRefPubMed

14.

Massin V, Werthel JD, Jaloux C. Safety and reliability of the dorsal percutaneous approach for non-displaced hook of hamate fracture: an anatomical study. J Hand Surg Eur Vol. 2021;46:678–9. https://doi.org/10.1177/1753193421991761.CrossRefPubMed

15.

Wang K, Ju JH, Jin GZ, Guo LP, Guo QW. Application of dorsal supporting plate for treatment of the fourth and fifth carpometacarpal joint fractures and dislocations. Chin J Hand Surg. 2019;35:1–3.

Title: Bennett fracture combined with hamate fracture: carpometacarpal joint ‘diagonal’ fracture and dislocation: a case report
Authors: Wei-Bin Wu
Yun-Feng Du
Hong-Xing Wang
Feng Liang
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Computed Tomography
Computed Tomography
Published in: BMC Musculoskeletal Disorders / Issue 1/2023
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-023-06588-3

ERS Congress 2024

Springer Medicine

Bennett fracture combined with hamate fracture: carpometacarpal joint ‘diagonal’ fracture and dislocation: a case report

Abstract

Background

Case presentation

Conclusion

ERS Congress 2024

Springer Medicine

Abstract

Background

Case presentation

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2023

Prevalence of sarcopenia in older women and level of agreement between the diagnostic instruments proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2)

Investigating the association between the symptoms of women with Fibromyalgia, Digestive function, and markers of the microbiota of the Gastrointestinal Tract (The FIDGIT Study): study protocol

Increased synovial immunohistochemistry reactivity of TGF-β1 in erosive peripheral psoriatic arthritis

Definition of irreparable rotator cuff tear: a scoping review of prospective surgical therapeutic trials to evaluate current practice

Hounsfield units predicts the occurrence but not the patterns of proximal humerus fracture in the elderly patients

Global prevalence of musculoskeletal disorders among physiotherapists: a systematic review and meta-analysis