Top

Journal of Medical Case Reports

Published in:

Open Access 01-12-2018 | Case report

Divergent dislocation of the carpometacarpal joints: a case report

Authors: Redouane Hani, Idriss Jeddi, Mohamed Saleh Berrada

Published in: Journal of Medical Case Reports | Issue 1/2018

Abstract

Background

Divergent carpometacarpal joint dislocations of the fingers are very rare. Due to severe swelling and overlapping of bones on a radiograph of the wrist and hand, dislocations are missed. The purpose of this clinical case report is to highlight this unusual injury to avoid missing diagnosis.

Case presentation

We report a case of a 24-year-old Moroccan man, an athlete, who presented divergent carpometacarpal joint fracture-dislocations of the ulnar four fingers after a fall during a national cycling competition. Radiographs showed divergent dislocation and associated fractures. He underwent open reduction and fixation with percutaneous Kirschner wires followed by 6 weeks of immobilization. Active physiotherapy was started and the results were satisfactory after a 2-year follow-up.

Conclusions

Divergent carpometacarpal joint dislocations of the fingers are exceptional; their diagnosis is sometimes difficult and may go unnoticed especially in a patient with polytrauma. The functional prognosis depends on the precocity of diagnosis and the quality of the reduction and rehabilitation.

Lawlis JF 3rd, Gunther SF. Carpometacarpal dislocations: long-term follow-up. J Bone Joint Surg Am. 1991;73(1):52–9.CrossRefPubMed

Guimaraes RM, Benaissa S, Moughabghab M, Dunaud JL. Les luxations carpométacarpiennes des doigts longs. À propos de 26 cas dont 20 cas revus. Rev Chir Orthop Reparatrice Appar Mot. 1996;82:598–607.PubMed

Yadav V, Marya KM. Divergent multiple carpometacarpal fracture dislocation. J Orthop Traumatol. 2002;3:113–5. https://doi.org/10.1007/s101950200038.CrossRef

Kumar R, Malhotra R. Divergent fracture-dislocation of the second carpometacarpal joint and the three ulnar carpometacarpal joints. J Hand Surg. 2001;26A:123–9.CrossRef

Agarwal A, Agarwal R. An unusual farm injury: divergent carpometacarpal joint dislocations. J Hand Surg Br. 2005;30(6):633–4. https://doi.org/10.1016/j.jhsb.2005.06.020.CrossRefPubMed

Sharma AK, John JT. Unusual case of carpometacarpal dislocation of all the four fingers of ulnar side of hand. Med J Armed Forces India. 2005;61(2):188–9.CrossRefPubMedPubMedCentral

Latifi M, Chafik R, Madhar M, Essadki B, Fikry T. La luxation carpométacarpienne antérieure complète des doigts. À propos d’un cas. Chir Main. 2005;24:106–8.CrossRefPubMed

Iqbal MJ, Saleemi A. Indian salutation test in acute dorsal carpometacarpal joint dislocation of the ulnar four fingers. Am J Emerg Med. 2003;21:74–6.CrossRefPubMed

Gilula LA. Carpal injuries: analytic approach and case exercises. AJR Am J Roentgenol. 1979;133(3):503–17.CrossRefPubMed

10.

Hartwig RH, Louis DS. Multiple carpometacarpal dislocations: a review of four cases. J Bone Joint Surg. 1979;61A:906–8.CrossRef

11.

Harwin SF, Fox JM, Sedlin ED. Volar dislocation of the bases of the second and third metacarpals. A case report. J Bone Joint Surg Am. 1975;57:849–51.CrossRefPubMed

12.

Jilani LZ, Abbas M, Goel S, Akhtar MN. Multiple volar dislocations of the carpometacarpal joints with an associated fracture of the first metacarpal base. Chin J Traumatol. 2014;17(1):38–40.PubMed

Title: Divergent dislocation of the carpometacarpal joints: a case report
Authors: Redouane Hani
Idriss Jeddi
Mohamed Saleh Berrada
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2018
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-018-1695-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Divergent dislocation of the carpometacarpal joints: a case report

Abstract

Background

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Button battery removed from the stomach resulting in a missed aortoesophageal fistula – a multidisciplinary approach to rescuing a very young patient: a case report

Novel variant of reversed midgut rotation – retro-arterial proximal jejunum and transverse colon: a case report and review of the literature

Intestinal paracoccidioidomycosis resembling Crohn’s disease in a teenager: a case report

Long-term familial Mediterranean fever remission on successful hepatitis C virus treatment in a patient not responding to colchicine: a case report

Management of irreducible unilateral facet joint dislocations in subaxial cervical spine: two case reports and a review of the literature

Exceptional mucocutaneous manifestations with amyloid nephropathy: a case report