Fracture-dislocations of the carpometacarpal joints of the ring and little finger

2014 ◽  
Vol 40 (1) ◽  
pp. 84-87 ◽  
Author(s):  
S. V. Gehrmann ◽  
R. A. Kaufmann ◽  
J. P. Grassmann ◽  
T. Lögters ◽  
M. Schädel-Höpfner ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Carpometacarpal Joint ◽  
Level Of Evidence ◽  
Carpometacarpal Joints ◽  
Functional Differences ◽  
Pin Fixation ◽  
Fracture Dislocations ◽  
Little Finger

We report the functional and radiographic results of 16 patients with fracture-dislocations of the ring and little finger carpometacarpal joints and 23 cases with fracture-dislocations of only the little finger carpometacarpal joint treated between 2006 and 2012. The above two cohort populations of patients were treated with either open reduction and pin fixation or closed reduction and pin fixation. These patients were followed for a mean of 13 months (range 9 to 48). The DASH scores for patients with fracture-dislocations of the ring and little finger carpometacarpal joints were 6.0 and of the little finger carpometacarpal joint 7.2. We found no functional differences in term of DASH scores after treatment between patients with fracture-dislocations of only the little finger carpometacarpal joint and both the ring and little finger carpometacarpal joints. Level of evidence: IV

Open Reduction for Dorsal Dislocation of Second to Fifth Carpometacarpal Joints: A Case Report

2020 ◽  
Author(s):  
Hiroo Kimura ◽  
Akira Toga ◽  
Taku Suzuki ◽  
Takuji Iwamoto
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Delayed Diagnosis ◽  
Preoperative Assessment ◽  
Radiographic Examination ◽  
Clinical Images ◽  
Left Hand ◽  
Carpometacarpal Joints ◽  
Joint Deformity ◽  
Poor Outcomes

Abstract Background Fracture-dislocations of all four ulnar (second to fifth) carpometacarpal (CMC) joints are rare hand injuries and frequently overlooked or missed. These injuries can be treated conservatively when closed reduction is successfully achieved, though they are sometimes irreducible and unstable. Case Description We report the case of a 17-year-old boy involved in a vehicular accident. Clinical images showed dorsal dislocation of all four ulnar CMC joints of the left hand associated with a fracture of the base of the fourth metacarpal. Although closed reduction was attempted immediately, the affected joints remained unstable and easily redislocated. Therefore, we performed open reduction and percutaneous fixation of all ulnar CMCs. He showed excellent recovery after 1 year postoperatively, reported no pain, and demonstrated complete grip strength and range of motion of the affected wrist and fingers. Literature Review Accurate clinical diagnosis of this lesion is difficult because of polytrauma, severe swelling masking the dislocated CMC joint deformity, and overlapping of adjacent metacarpals and carpal bones on radiographic examination. As for the treatment strategy, it has yet to obtain a consensus. Some reports value open reduction to guarantee anatomical reduction, and it is definitely needed in the patients with interposed tissues to be removed or with subacute and chronic injuries. Clinical Relevance Delayed diagnosis or treatment could lead to poor outcomes. Therefore, surgeons must be aware that precise preoperative assessment is critical, and anatomical open reduction of interposed bony fragments, like our case, may be required even in an acute phase.

Translunate, Transmetacarpal, Scapho-Radial Fracture with Perilunate Dislocation A Case Report

1985 ◽  
Vol 10 (3) ◽  
pp. 382-384
Author(s):  
P. TOFT ◽  
K. BERTHEUSSEN ◽  
S. OTKJAER
Keyword(s):  
Case Report ◽  
Avascular Necrosis ◽  
Closed Reduction ◽  
Open Reduction ◽  
X Rays ◽  
Radial Fracture ◽  
Perilunate Dislocation ◽  
Carpal Fracture ◽  
Fracture Dislocations

A case translunate, transmetacarpal, scapho-radial fracture with perilunate dislocation occurred as a young man drove his motorcycle into the side of a car. Closed reduction was performed initially. Open reduction was performed with a screw in the lunate. Eighteen months later the screw was removed and after two and a half years x-rays revealed no signs of avascular necrosis or arthrosis. The patient fully recovered. This case stresses the necessity of open reduction in cases of complicated carpal fracture dislocations.

Closed Reduction and Percutaneous Pinning in Fracture-Dislocations of Carpometacarpal Joints

2001 ◽  
Vol 36 (3) ◽  
pp. 199 ◽  
Author(s):  
Seung Ju Jeon ◽  
Hyung Ku Yoon ◽  
Kang Woo Jung ◽  
Yong Jae Lee ◽  
Kyoung Sun Noh
Keyword(s):  
Closed Reduction ◽  
Percutaneous Pinning ◽  
Carpometacarpal Joints ◽  
Fracture Dislocations

Flexible Fixation Technique for Lisfranc Injuries

2019 ◽  
Vol 40 (11) ◽  
pp. 1338-1345 ◽  
Author(s):  
Connor Delman ◽  
Midhat Patel ◽  
Mark Campbell ◽  
Christopher Kreulen ◽  
Eric Giza
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Treatment Options ◽  
Percutaneous Pinning ◽  
Fixation Device ◽  
Fixation Technique ◽  
Level Of Evidence ◽  
Fracture Dislocations ◽  
Lisfranc Injuries ◽  
Joint Treatment

Injuries to the Lisfranc complex range from purely ligamentous disruptions to fracture-dislocations of the tarsometatarsal joint. Treatment options include closed/open reduction with percutaneous pinning, open reduction and internal fixation (ORIF), and primary arthrodesis. We present a ligament reinforcement technique utilizing a flexible fixation device for the treatment of ligamentous Lisfranc injuries. Level of Evidence: Level V, expert opinion.

scholarly journals Isolated ulnopalmar dislocation of 5th carpometacarpal joint: a rare case report

2021 ◽  
Vol 7 (6) ◽  
pp. 1231
Author(s):  
Pratheeksh P. ◽  
Manjunath S. Japatti ◽  
Ranganatha B. Thimmegowda ◽  
Rakshith Kumar K.
Keyword(s):  
Case Report ◽  
Functional Outcome ◽  
Open Reduction ◽  
Rare Case ◽  
Carpometacarpal Joint ◽  
Carpometacarpal Joints ◽  
Rare Case Report ◽  
Standard Radiographs ◽  
High Degree

<p class="abstract">Isolated volar dislocations of the fifth carpometacarpal joints are an uncommon injury. They are classified as ulnopalmar or radiopalmar dislocations. It can be easily missed on standard radiographs. A high degree of suspicion and accurate reduction is pivotal in restoring the functional outcome of the hand. In our case report, a forty year old man presented with ulnopalmar dislocation of the fifth carpometacarpal joint and was treated with open reduction and K wiring. We review the literature and discuss the available methods of management.</p>

Dislocation of Carpometacarpal Joint of the Little Finger

1987 ◽  
Vol 12 (2) ◽  
pp. 260-263
Author(s):  
V. T. CHEN
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Carpometacarpal Joint ◽  
Little Finger

A case is reported of late ulna-volar carpometacarpal dislocation of the left little finger, treated by open reduction and internal fixation.

An Uncommon Presentation of Fracture-dislocation of the 4th and 5th Carpometacarpal Joints with Volar Displacement and its Management

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Nikhil Jawaharlal ◽  
Vasanthakumar Ramsingh ◽  
Vijaya Bhalaik
Keyword(s):  
Kirschner Wire ◽  
Fracture Dislocation ◽  
Carpometacarpal Joint ◽  
Carpometacarpal Joints ◽  
Kirschner Wire Fixation ◽  
Joint Fracture ◽  
Satisfactory Outcome ◽  
Uncommon Presentation ◽  
Fracture Dislocations ◽  
Poor Outcomes

Introduction: Carpo-metacarpal joint fracture-dislocations are rare injuries. They constitute less than 1% of all hand injuries [1]. They often go unnoticed [2]. Of these, dorsal fracture-dislocations on the ulnar side are more commonly seen [3] because of the greater stabilizing dorsal structures. Volar fracture-dislocations are very rare and difficult to diagnose for which, one should have a keen eye on. Case Report: This is a case of a 51-year-old female with a closed injury to her wrist. With clinical suspicion and appropriate radiographs fracture-dislocation of the 4th and 5th carpometacarpal joints with volar displacement was diagnosed. She underwent closed reduction and percutaneous Kirschner wire fixation, followed by 6 weeks of immobilization. At the final follow-up in 4 months, the patient was noted to have a satisfactory outcome following intense physiotherapy. Conclusion: Fourth and fifth carpometacarpal joint fracture-dislocations of the fingers are unique; their diagnosis can be challenging and often overlooked [4], which if missed can have very poor outcomes. The functional prognosis depends on the precocity of diagnosis and appropriate reduction and vigorous rehabilitation. Keywords: Carpometacarpal joint, fracture-dislocation, volar displacement, wrist injury.

Mallet fingers with bone avulsion and DIP joint subluxation

2014 ◽  
Vol 40 (1) ◽  
pp. 8-15 ◽  
Author(s):  
T. Wada ◽  
T. Oda
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Nonoperative Treatment ◽  
Injury Pattern ◽  
Distal Phalanx ◽  
Percutaneous Pinning ◽  
Insufficient Evidence ◽  
Level Of Evidence

One-third of all mallet fingers are associated with a fracture. Mallet fractures associated with large fracture fragments may result in volar subluxation of the distal phalanx. The management of mallet fractures varies based on injury pattern and surgeon preference. These treatment options include splinting regimens, closed reduction and percutaneous pinning and open reduction and internal fixation. Although numerous surgical techniques have been described, there is little clear consensus on operative treatment. Moreover, there is insufficient evidence to support operative over nonoperative treatment for mallet fractures. Level of evidence: Level V

scholarly journals Anatomic Repair vs Closed Reduction of the Syndesmosis

2021 ◽  
pp. 107110072199000
Author(s):  
Al-Walid Hamam ◽  
Moaz Bin Yunus Chohan ◽  
Christina Tieszer ◽  
Abdel-Rahman Lawendy ◽  
Christopher Del Balso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Outcome Measures ◽  
Closed Reduction ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Screw Fixation ◽  
Secondary Outcome ◽  
Level Of Evidence ◽  
Significant Difference

Background: The goal of the study was to compare radiographic and functional outcomes between conventional closed syndesmotic reduction and screw fixation with open reduction, direct repair of the anterior inferior tibiofibular ligament (AiTFL) and screw fixation. We hypothesized that open reduction with restoration of the AiTFL would provide an improved reduction with better radiographic and functional outcomes. Methods: Fifty consecutive patients with OTA 44-C ankle fractures were enrolled. Treatment was nonrandomized and based on surgeon preference. Patients were treated with either open reduction, suture-anchor AiTFL repair, and screw fixation (ART group), or conventional closed reduction of the syndesmosis followed by screw fixation (CR group). The primary outcome measure was anteroposterior (AP) displacement of the fibula on CT scan at 3 months postoperatively. Secondary outcome measures included the Maryland Foot Score, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle Hindfoot Score, and the Foot and Ankle Outcome Score (FAOS). Results: Mean AP difference between injured and noninjured ankles was decreased in the ART group compared with the CR group (0.7 ± 0.3 mm vs 1.5 ± 0.3 mm, P = .008). No differences were observed between groups in overall scores for secondary outcome measures. The ART group displayed a significant difference in Maryland Foot Shoe subscore at 12 months (ART = 9.5 vs CR = 8.3, P = .03) and FAOS Quality of Life subscore at 12 months (64.1 compared to 38.3, P = .04). Conclusions: Open anatomic syndesmotic repair resulted in improved radiographic outcomes compared with closed reduction. Cosmesis was worse at 6 weeks compared to the CR group; however, quality of life and shoewear were improved in the ART group at 1 year postoperatively. Level of Evidence: Level II, prospective comparative study.

Temporizing External Fixation vs Splinting Following Ankle Fracture Dislocation

2019 ◽  
Vol 41 (2) ◽  
pp. 177-182
Author(s):  
Richard A. Wawrose ◽  
Leonid S. Grossman ◽  
Matthew Tagliaferro ◽  
Peter A. Siska ◽  
Gele B. Moloney ◽  
...  
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Closed Reduction ◽  
Ankle Fracture ◽  
Skin Necrosis ◽  
Fracture Dislocation ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Loss Of Reduction ◽  
Fracture Dislocations

Background: Closed reduction and splinting followed by outpatient management is standard of care for temporizing most ankle fractures. However, ankle fracture-dislocation potentially warrants a different approach based on the propensity for loss of reduction. The purpose of this study was to determine the rate of complications associated with closed reduction and splinting of unstable ankle fracture-dislocations. Further, we sought to determine the efficacy of immediate external fixation as an alternative to splinting in cases too swollen for acute operation. Methods: This retrospective chart review analyzed all ankle-fracture dislocations that came through a large health care system from 2008 to 2018. Patients managed with acute open reduction internal fixation (ORIF) and open fractures were excluded. In patients managed late, the cohorts were divided into those temporized with closed reduction/splinting vs external fixation. Reduction quality and splint technique were additionally assessed in splinted patients. A total of 354 closed ankle fracture-dislocations were identified: 298 patients (84%) underwent ORIF within 48 hours and were excluded; 28 (15 female/13 male, average age 46.8 years) were placed in an external fixator and 28 (22 female/6 male, average age 57.2 years) were reduced, splinted, and discharged. Results: At follow-up, 14 of the patients (50%) in the splint group developed loss of reduction and 5 of these patients (17.6%) developed anteromedial skin necrosis from skin tenting. None of the patients in the ex-fix group developed loss of reduction or skin necrosis. The rate of redislocation and the rate of development of skin necrosis was statistically higher in cases temporized with a splint versus an external fixator ( P < .01 and P = .05, respectively). Conclusion: We found that in ankle fracture-dislocations not treated with acute ORIF, splint immobilization was associated with an increased risk of complications, including redislocation and skin necrosis, when compared to a temporizing external fixator. Level of Evidence: Level III, retrospective comparative study.

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