Abstract
BackgroundIsolated thumb carpometacarpal dislocation is a rare injury pattern and the optimal treatment option is still controversial.Case DescriptionWe present a 27-year-old basketball player who underwent an isolated dorsal dislocation of the thumb carpometacarpal joint after a fall. The dislocation was successfully reduced by closed means but the joint was found to be grossly unstable. Due to inherent instability, repair of the ruptured dorsoradial ligament and joint capsule was performed.The ligament was detached from its proximal insertion into trapezium and subsequently stabilized via suture anchors. The torn capsule was repaired in an end-to-end fashion and immobilization of the joint was applied for 6 weeks.ResultsAt 3-year follow up evaluation the patient was pain free and returned to his previous level of activity. No restriction of carpometacrpal movements or residual instability was noticed. Radiographic examination showed normal joint alignment and no signs of subluxation or early osteoarthritis.ConclusionSurgical stabilization of the dorsal capsuloligamentous complex may be considered the selected treatment option in isolated carpometacarpal joint dislocations, that remain unstable after closed reduction in young and high demand patients.Level of Clinical Evidence: Level IV
Highlights
Isolated dislocation of the carpometacarpal (CMC) joint of the thumb is an uncommon upper limb and hand injury
Surgical stabilization of the dorsal capsuloligamentous complex may be considered the selected treatment option in isolated carpometacarpal joint dislocations, that remain unstable after closed reduction in young and high demand patients
The optimal treatment strategy for the acute thumb CMC joint dislocation remains a subject of debate
Summary
Isolated dislocation of the carpometacarpal (CMC) joint of the thumb is an uncommon upper limb and hand injury. The optimal treatment strategy for the acute thumb CMC joint dislocation remains a subject of debate. Closed reduction and casting, closed or open reduction along with transfixion with Kirschner wires and reconstruction of dorsal ligament and capsuloraphy have been performed so far according to joint stability and surgeon’s preference. Isolated thumb carpometacarpal dislocation is a rare injury pattern and the optimal treatment option is still controversial. Case Description: We present a 27-year-old basketball player who underwent an isolated dorsal dislocation of the thumb carpometacarpal joint after a fall. Repair of the ruptured dorsoradial ligament and joint capsule was performed. The torn capsule was repaired in an end-to-end fashion and immobilization of the joint was applied for 6 weeks
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