Abstract
Posterior carpometacarpal (CMC) dislocation is a rare condition. Treatment is usually surgical though no strict consensus can be found upon literature review. If diagnosed early and no associated fractures are found, CMC dislocation could benefit from conservative treatment comprising closed reduction and splint immobilisation. We report the case of a 26-year-old man diagnosed with a posterior dislocation of the third, fourth, and fifth CMC joints after a fall of 1.5 meters, treated by external reduction under procedural sedation and immobilisation with a cast for 6 weeks. Evolution was excellent with no relapse observed during follow-up. Our aim is to increase physician awareness of CMC dislocation so that they seek this injury in the emergency department. Unrecognised CMC dislocation can lead to neurovascular injuries as well as chronic instability and early articular degeneration.
Highlights
Carpometacarpal (CMC) dislocation is a rare condition usually treated surgically [1, 2]
Most posterior dislocations are due to high velocity trauma
We report the case of a 26-yearold man suffering from a posterior dislocation of the third, fourth, and fifth CMC joints after a fall of less than 1.5 meters, treated conservatively
Summary
Carpometacarpal (CMC) dislocation is a rare condition usually treated surgically [1, 2]. Posterior dislocation is more common (85%) than palmar dislocation [3]. Most posterior dislocations are due to high velocity trauma. Delayed treatment can result in neurovascular injuries due to oedema [3] and prolonged compression. Untreated, these lesions can result in chronic instability of the CMC joints and early articular degeneration [4]. We report the case of a 26-yearold man suffering from a posterior dislocation of the third, fourth, and fifth CMC joints after a fall of less than 1.5 meters, treated conservatively
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