Carpometacarpal Dislocation with Third Metacarpal Fracture

Case Presentation: A 17-year-old male presented to the emergency department (ED) due to trauma to the right hand and wrist after punching a locker at school. He had significant soft tissue swelling. Radiographs demonstrated intra-articular metacarpal fractures with associated carpometacarpal disloca...

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Autores principales:	Colin Jorgensen, Steve C. Christos
Formato:	article
Lenguaje:	EN
Publicado:	eScholarship Publishing, University of California 2021
Materias:	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/3fadd5fa4b0b4a12a345da03c8e5c7ac
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spelling	oai:doaj.org-article:3fadd5fa4b0b4a12a345da03c8e5c7ac2021-11-23T20:02:52ZCarpometacarpal Dislocation with Third Metacarpal Fracture2474-252X10.5811/cpcem.2021.9.53202https://doaj.org/article/3fadd5fa4b0b4a12a345da03c8e5c7ac2021-11-01T00:00:00Zhttps://escholarship.org/uc/item/3762c2cmhttps://doaj.org/toc/2474-252XCase Presentation: A 17-year-old male presented to the emergency department (ED) due to trauma to the right hand and wrist after punching a locker at school. He had significant soft tissue swelling. Radiographs demonstrated intra-articular metacarpal fractures with associated carpometacarpal dislocations. The dislocation was reduced bedside in the ED and ultimately underwent closed reduction surgical management with orthopedic surgery. Discussion: Metacarpal fractures result from high-force impact injuries and account for 30–40% of all hand injuries. The most common sites of second through fifth metacarpal fractures are at the neck and the shaft, with the majority involving the fifth metacarpal neck (commonly coined “boxer’s fractures”). Carpometacarpal (CMC) dislocations are a rare injury associated with high-force impact trauma to the wrist. These injuries account for as little as 1% of all acute hand and wrist injuries. 1, 2 Carpometacarpal dislocations are often difficult to diagnose on physical examination due to significant soft tissue swelling, and they can easily be missed on anterior-posterior views of the hand. Lateral and oblique plain radiograph views are essential in the diagnosis as they are more likely to show dislocations. Despite appropriate plain radiographic views, subtle CMC dislocations may be difficult to discern dependent on the level of dislocation or subluxation and overlapping of joints. These injuries are rare due to otherwise highly stable ligamentous and muscular attachments within the wrist. Because of these attachments, dislocations are often associated with concomitant metacarpal fractures. 3Colin JorgensenSteve C. ChristoseScholarship Publishing, University of CaliforniaarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENClinical Practice and Cases in Emergency Medicine, Vol 5, Iss 4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Colin Jorgensen Steve C. Christos Carpometacarpal Dislocation with Third Metacarpal Fracture
description	Case Presentation: A 17-year-old male presented to the emergency department (ED) due to trauma to the right hand and wrist after punching a locker at school. He had significant soft tissue swelling. Radiographs demonstrated intra-articular metacarpal fractures with associated carpometacarpal dislocations. The dislocation was reduced bedside in the ED and ultimately underwent closed reduction surgical management with orthopedic surgery. Discussion: Metacarpal fractures result from high-force impact injuries and account for 30–40% of all hand injuries. The most common sites of second through fifth metacarpal fractures are at the neck and the shaft, with the majority involving the fifth metacarpal neck (commonly coined “boxer’s fractures”). Carpometacarpal (CMC) dislocations are a rare injury associated with high-force impact trauma to the wrist. These injuries account for as little as 1% of all acute hand and wrist injuries. 1, 2 Carpometacarpal dislocations are often difficult to diagnose on physical examination due to significant soft tissue swelling, and they can easily be missed on anterior-posterior views of the hand. Lateral and oblique plain radiograph views are essential in the diagnosis as they are more likely to show dislocations. Despite appropriate plain radiographic views, subtle CMC dislocations may be difficult to discern dependent on the level of dislocation or subluxation and overlapping of joints. These injuries are rare due to otherwise highly stable ligamentous and muscular attachments within the wrist. Because of these attachments, dislocations are often associated with concomitant metacarpal fractures. 3
format	article
author	Colin Jorgensen Steve C. Christos
author_facet	Colin Jorgensen Steve C. Christos
author_sort	Colin Jorgensen
title	Carpometacarpal Dislocation with Third Metacarpal Fracture
title_short	Carpometacarpal Dislocation with Third Metacarpal Fracture
title_full	Carpometacarpal Dislocation with Third Metacarpal Fracture
title_fullStr	Carpometacarpal Dislocation with Third Metacarpal Fracture
title_full_unstemmed	Carpometacarpal Dislocation with Third Metacarpal Fracture
title_sort	carpometacarpal dislocation with third metacarpal fracture
publisher	eScholarship Publishing, University of California
publishDate	2021
url	https://doaj.org/article/3fadd5fa4b0b4a12a345da03c8e5c7ac
work_keys_str_mv	AT colinjorgensen carpometacarpaldislocationwiththirdmetacarpalfracture AT stevecchristos carpometacarpaldislocationwiththirdmetacarpalfracture
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Carpometacarpal Dislocation with Third Metacarpal Fracture

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