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Mattia A, Buchanan PJ, Chopan M, Chim H. Axial-Radial-Ulnar Carpal Dislocation with Divergent Intermetacarpal Dislocations, Peritrapezoid and Scaphotrapezial Dislocations: A Case Report. J Hand Surg Asian Pac Vol 2024; 29:59-63. [PMID: 38299251 DOI: 10.1142/s2424835524720019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
We report a patient with a severe axial-radial-ulnar (ARU) fracture dislocation of the carpus, involving multiple intermetacarpal dislocations as well as divergent carpometacarpal dislocations involving the index, long, ring and small fingers and peritrapezoid and scaphotrapezial dislocations. She also had a degloving injury involving the dorsal hand. Emergent debridement followed by open reduction and internal fixation of all injuries was performed, followed by soft tissue management. At 6-year follow-up, the patient had adequate active range of motion with the ability to make a full fist and was able to use her wrist and hand for most activities of daily living. Disabilities of the arm, shoulder and hand (DASH) score was 47.5. Michigan hand outcomes questionnaire (MHQ) score was 66.8. Mayo wrist score was 65. Patient-rated wrist evaluation (PRWE) score was 42. Severe ARU fracture dislocations of the carpus can result in adequate functional recovery on long-term follow-up. Level of Evidence: Level V (Therapeutic).
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Affiliation(s)
| | - Patrick J Buchanan
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Mustafa Chopan
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Harvey Chim
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL, USA
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Amine HM, Reda L, Assouab O, Boufettal M, Bassir RA, Mekkaoui J, Lamrani MO, Kharmaz M, Berrada MS. Hamatometacarpal fracture-dislocation: A case report. Trauma Case Rep 2023; 48:100966. [PMID: 38098809 PMCID: PMC10719451 DOI: 10.1016/j.tcr.2023.100966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 12/17/2023] Open
Abstract
Hamatometacarpal fracture-dislocation is a rare condition. Only a few cases have been reported in the literature. We present the case of a 26-year-old male patient who sustained a coronal fracture of the body of the hamate with the fifth metacarpal base interposed between volar and dorsal fragments on his right dominant hand. The patient underwent open reduction and internal fixation of the hamate with a 2.0-mm cortical screw and stabilization of the dislocated fifth metacarpal with Kirschner wire. At six months follow-up, total range of movement was allowed, the patient experienced no pain, and had successfully returned to work.
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Affiliation(s)
- Haouzi Mohammed Amine
- Department of Orthopaedic Surgery & Traumatology, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Lafdil Reda
- Department of Orthopaedic Surgery & Traumatology, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Oualid Assouab
- Department of Orthopaedic Surgery & Traumatology, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Moncef Boufettal
- Department of Orthopaedic Surgery & Traumatology, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Reda Allah Bassir
- Department of Orthopaedic Surgery & Traumatology, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Jalal Mekkaoui
- Department of Orthopaedic Surgery & Traumatology, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Moulay Omar Lamrani
- Department of Orthopaedic Surgery & Traumatology, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Mohammed Kharmaz
- Department of Orthopaedic Surgery & Traumatology, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
| | - Mohammed Saleh Berrada
- Department of Orthopaedic Surgery & Traumatology, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco
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Lai CC, Fang HW, Chang CH, Pao JL, Chang CC, Chen YJ. Unusual capitate fracture with dorsal shearing pattern and concomitant carpometacarpal dislocation with a 6-year follow-up: A case report. World J Clin Cases 2023; 11:2060-2066. [PMID: 36998955 PMCID: PMC10044964 DOI: 10.12998/wjcc.v11.i9.2060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/10/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Isolated capitate fractures are rare carpal fractures. Following high-energy injuries, capitate fractures are usually associated with other carpal fractures or ligament injuries. The management of capitate fractures depends on the fracture pattern. Here, we report an unusual capitate fracture with a dorsal shearing pattern and concomitant carpometacarpal dislocation, with a 6-year follow-up. To the best of our knowledge, this fracture pattern and surgical management have not been previously reported.
CASE SUMMARY A 28-year-old man presented with left-hand volar tenderness and decreased grip strength that persisted for one month after a traffic accident. Radiography showed a distal capitate fracture with carpometacarpal joint incongruence. Computed tomography (CT) revealed a distal capitate fracture with carpometacarpal joint dislocation. The distal fragment was rotated by 90° in the sagittal plane, and an oblique shearing fracture pattern was noted. Open reduction and internal fixation (ORIF) with a locking plate were performed using the dorsal approach. The imaging studies performed 3 mo and 6 years following surgery revealed a healed fracture, and the Disabilities of the Arm, Shoulder, and Hand and visual analog scale scores were significantly improved.
CONCLUSION CT can detect capitate fractures with dorsal shearing pattern and concomitant carpometacarpal dislocation. ORIF using a locking plate are possible.
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Affiliation(s)
- Chien-Cheng Lai
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei 106, Taiwan
| | - Hsu-Wei Fang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei 106, Taiwan
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan 320, Taiwan
| | - Jwo-Luen Pao
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
| | - Chun-Chien Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
| | - Yeong-Jang Chen
- Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, Taiwan
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Piereschi S, Remy H, Camuzard O. Volar fracture dislocation of the 2nd metacarpal base associated with acute carpal tunnel syndrome: A case report. ANN CHIR PLAST ESTH 2020; 66:180-183. [PMID: 32763069 DOI: 10.1016/j.anplas.2020.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/08/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
Posttraumatic acute carpal tunnel syndrome is a not a usual complication in traumatic hand injuries but requires more urgent and aggressive management. Compression of the median nerve should be systematically sought when there is a major and painful swelling of the hand, associated with one or several hand and wrist fractures. In rare case, a single metacarpal fracture or dislocation can be the only cause of median nerve compression and requires urgent diagnosis. If missed or neglected irreversible damage could occur to the median nerve. If surgery is perform in a timely manner outcomes are excellent, with complete recovery in most of the cases. We present the case of a 24-year-old man with an acute compression of the median nerve due to an intra-articular fracture of the 2nd metacarpal base. A bony fragment shifting from the base of 2nd metacarpal was found in the carpal tunnel participating, at least in part, in the compression of the median nerve.
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Affiliation(s)
- S Piereschi
- Institut Universitaire Locomoteur et du Sport (IULS), Service de Chirurgie Réparatrice et de la Main, CHU de Nice, Hôpital Pasteur 2, Nice, France
| | - H Remy
- Institut Universitaire Locomoteur et du Sport (IULS), Service de Chirurgie Réparatrice et de la Main, CHU de Nice, Hôpital Pasteur 2, Nice, France
| | - O Camuzard
- Institut Universitaire Locomoteur et du Sport (IULS), Service de Chirurgie Réparatrice et de la Main, CHU de Nice, Hôpital Pasteur 2, Nice, France; Laboratoire d'Anatomie humaine, Faculté de Médecine de Nice, Université Côte d'Azur, Nice, France.
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Hassini L, Mouelhi T, Khalifa MA, Mtaoumi M, Ben Ayeche ML. Ulnar paddlefish carpometacarpal dislocation of the three lesser fingers: a case report. Pan Afr Med J 2018. [PMID: 29541301 PMCID: PMC5847124 DOI: 10.11604/pamj.2017.28.155.12517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The long fingers’ paddlefish carpometacarpal (CMC) dislocation is exceptional. Most dislocations occur after high energy trauma. Untreated, these lesions can result in chronic instability of the CMC joints and early osteoarthritis. We report the case of a 20-year-old patient presenting with an ulnar paddlefish CMC fracture-dislocation of the three lesser fingers resulting from a hand trauma in the context of an occupational accident. 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.
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Affiliation(s)
- Lassaad Hassini
- Department of Orthopaedic Surgery, University Hospital Sahloul, Sousse, Tunisia
| | - Thabet Mouelhi
- Department of Orthopaedic Surgery, University Hospital Sahloul, Sousse, Tunisia
| | - Mohamed Ali Khalifa
- Department of Orthopaedic Surgery, University Hospital Sahloul, Sousse, Tunisia
| | - Mourad Mtaoumi
- Department of Orthopaedic Surgery, University Hospital Sahloul, Sousse, Tunisia
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Abstract
INTRODUCTION Isolated pure dislocation of the fifth carpometacarpal (CMC) joint is a very rare injury and classified depending on displacement of the metacarpal base. This rare injury is often difficult to recognize and is liable to be overlooked. The purpose of this case report is to present a patient with an isolated dislocation of the fifth CMC joint that was satisfactorily treated with closed reduction and ulnar gutter pop slab. CASE REPORT A 21-year-old male presented with severe pain on the right carpus following a fall with injury to right hand. There was a mild swelling at fifth CMC joint region and a bony prominence was felt dorsally, little finger presented an abduction deformity, and there was apparent shortening of the fifth ray. A diagnosis of isolated dislocation of fifth CMC dislocation was made based on radiographs. Immediate closed reduction was done in emergency room by applying longitudinal traction and direct pressure on metacarpal base dorsally, reduction was stable and confirmed by postreduction radiographs. CONCLUSION Isolated pure dislocation of the fifth CMC joint is very rare injury and is prone to be missed in emergency room and particular attention should be made to diagnose it in polytrauma patients.
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Affiliation(s)
- Rashid Anjum
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Roy
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - Kamran Farooque
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Sharma
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
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Jehanno P, Mas V, Fitoussi F, Frajman JM, Valenti P, Mazda K. [Metacarpal osteoarticular injuries in children]. Chir Main 2013; 32 Suppl 1:S29-S38. [PMID: 23796792 DOI: 10.1016/j.main.2013.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 01/05/2013] [Accepted: 02/16/2013] [Indexed: 06/02/2023]
Abstract
Metacarpal fractures and dislocations in the fingers are common injuries in children's hands. Most of these can be treated successfully non-operatively, although a subset requires more aggressive treatment. Results following appropriate care in children are generally good. Twenty percent of them need a reduction, need for surgical stabilization is rare. Each injury is presented, including diagnostic, therapeutic principles, pitfalls to prevent and potential complications.
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Affiliation(s)
- P Jehanno
- Urgences mains-enfants, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France.
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Sharma AK, John JT. Unusual Case of Carpometacarpal Dislocation of All the Four Fingers of Ulnar Side of Hand. Med J Armed Forces India 2011; 61:188-9. [PMID: 27407748 DOI: 10.1016/s0377-1237(05)80024-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2003] [Accepted: 12/29/2003] [Indexed: 11/16/2022] Open
Affiliation(s)
- A K Sharma
- Professor and Head, Department of Orthopaedics, Armed Forces Medical College, Pune-40
| | - John T John
- Ex-Resident, Department of Orthopaedics, Armed Forces Medical College, Pune-40
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