Carpometacarpal dislocation

Background

Ligaments of wrist. Posterior view.

• Also known as CMC joint
• Uncommon due to strong ligaments and insertions of wrist flexors/extensors

Clinical Features

• Cause is usually result of high-speed mechanisms
• Usually dislocates dorsally with associated fracture(s)

Differential Diagnosis

Hand and finger dislocations

• Finger dislocations
  • Distal interphalangeal dislocation (finger) (DIP)
  • Proximal interphalangeal dislocation (finger) (PIP)
  • Metacarpophalangeal dislocation (finger) (MCP)
• Thumb dislocations
  • Interphalangeal dislocation (thumb) (IP)
  • Metacarpophalangeal dislocation (thumb) (MCP)
• Hand dislocations
  • Carpometacarpal dislocation

Evaluation

• X-ray

Management

Reduction

• Traction and flexion with simultaneous longitudinal pressure on metacarpal base
• If unable to reduce or remains unstable, immobilize with both dorsal and volar splints for urgent hand surgeon referral

Disposition

• Refer to hand surgeon

See Also

• Hand and finger dislocations

External Links

Videos

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