Traumatic Isolated Thumb Carpometacarpal Joint Dislocation - Report of Two Clinical Cases^[*]

Abstract

Isolated thumb carpometacarpal joint dislocation is a rare lesion that accounts for less than 1% of all hand lesions.

The authors present two cases of traumatic isolated thumb carpometacarpal joint dislocation. One of them was treated with closed reduction and cast immobilization, and the other was treated with closed reduction, Kirschner-wires pinning, and cast immobilization.

The first patient had a good functional outcome and showed no signs of thumb carpometacarpal instability. The patient treated with Kirschner wires presented signs of clinical instability and radiological subluxation.

Isolated thumb carpometacarpal dislocation is a rare lesion that can cause joint instability, which interferes with the normal function of the hand and can lead to articular degenerative changes.

The best management of this lesion is still controversial, since there is lack of evidence in the literature showing superiority of one treatment over the other.

Keywords

joint dislocations - thumb - hand

Financial Support

There was no financial support from public, commercial, or non-profit sources.

^* Work developed at the Centro Hospitalar de Entre Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal.

Publikationsverlauf

Eingereicht: 30. Juli 2019

Angenommen: 12. Dezember 2019

Artikel online veröffentlicht:
29. Mai 2020

• Referências

• 1 Bosmans B, Verhofstad MH, Gosens T. Traumatic thumb carpometacarpal joint dislocations. J Hand Surg Am 2008; 33 (03) 438-441
• 2 McCarley M, Foreman M. Chronic Carpometacarpal Dislocation of the Thumb: A Case Report and Review of the Literature. JBJS Case Connect 2018; 8 (03) e49
• 3 Annappa R, Kotian P, , P JA, Mudiganty S. Ligamentous Reconstruction of Traumatic Dislocation of Thumb Carpometacarpal Joint: Case Report and Review of Literature. J Orthop Case Rep 2015; 5 (04) 79-81
• 4 Jeong C, Kim HM, Lee SU, Park IJ. Bilateral carpometacarpal joint dislocations of the thumb. Clin Orthop Surg 2012; 4 (03) 246-248
• 5 Lahiji F, Zandi R, Maleki A. First Carpometacarpal Joint Dislocation and Review of Literatures. Arch Bone Jt Surg 2015; 3 (04) 300-303
• 6 Fotiadis E, Svarnas T, Lyrtzis C, Papadopoulos A, Akritopoulos P, Chalidis B. Isolated thumb carpometacarpal joint dislocation: a case report and review of the literature. J Orthop Surg Res 2010; 5: 16
• 7 McCarthy CM, Awan HM. Trapeziometacarpal dislocation without fracture. J Hand Surg Am 2014; 39 (11) 2292-2293
• 8 Chan Y. A painful thumb. BMJ Case Rep 2013; 2013: bcr2013009349
• 9 Ansari MT, Kotwal PP, Morey VM. Primary repair of capsuloligamentous structures of trapeziometacarpal joint: A preliminary study. J Clin Orthop Trauma 2014; 5 (04) 185-192
• 10 Iyengar K, Gandham S, Nadkarni J, Loh W. Modified Eaton-Littler's Reconstruction for Traumatic Dislocation of the Carpometacarpal Joint of the Thumb-A Case Report and Review of Literature. J Hand Microsurg 2013; 5 (01) 36-42
• 11 Harvey FJ, Bye WD. Bennett's fracture. Hand 1976; 8 (01) 48-53
• 12 Pagalidis T, Kuczynski K, Lamb DW. Ligamentous stability of the base of the thumb. Hand 1981; 13 (01) 29-36
• 13 Strauch RJ, Behrman MJ, Rosenwasser MP. Acute dislocation of the carpometacarpal joint of the thumb: an anatomic and cadaver study. J Hand Surg Am 1994; 19 (01) 93-98
• 14 Shah J, Patel M. Dislocation of the carpometacarpal joint of the thumb. A report of four cases. Clin Orthop Relat Res 1983; (175) 166-169
• 15 Chen VT. Dislocation of the carpometacarpal joint of the thumb. J Hand Surg Br 1987; 12 (02) 246-251
• 16 Watt N, Hooper G. Dislocation of the trapezio-metacarpal joint. J Hand Surg Br 1987; 12 (02) 242-245
• 17 Jakobsen CW, Elberg JJ. Isolated carpometacarpal dislocation of the thumb. Case report. Scand J Plast Reconstr Surg Hand Surg 1988; 22 (02) 185-186
• 18 Simonian PT, Trumble TE. Traumatic dislocation of the thumb carpometacarpal joint: early ligamentous reconstruction versus closed reduction and pinning. J Hand Surg Am 1996; 21 (05) 802-806
• 19 Kural C, Malkoç M, Uğraş AA, Sen A. [Isolated carpometacarpal dislocation of the thumb: a case report]. Acta Orthop Traumatol Turc 2002; 36 (05) 446-448
• 20 Khan AM, Ryan MG, Teplitz GA. Bilateral carpometacarpal dislocations of the thumb. Am J Orthop 2003; 32 (01) 38-41
• 21 Slocum AMY, Lui TH. Isolated first carpometacarpal joint dislocation managed with closed reduction and splinting. BMJ Case Rep 2019; 12 (03) e228715
• 22 Eaton RG, Littler JW. Ligament reconstruction for the painful thumb carpometacarpal joint. J Bone Joint Surg Am 1973; 55 (08) 1655-1666