Overview
Open fracture dislocation of the carpometacarpal (CMC) joint involves significant disruption of the joint integrity, often affecting the thumb most commonly due to its unique anatomy and function 3. This condition can lead to severe functional impairment if not properly managed 3.Diagnosis
Clinical Presentation: Irreducible dislocation, pain, swelling, and limited range of motion 1.
Imaging: Radiographs essential for initial assessment; CT may be needed for complex dislocations 12.
Differential Diagnosis: Distinguish from mallet thumb and other thumb injuries 4.Management
First-Line Treatment: Open reduction and internal fixation for acute dislocations 2.
Salvage Procedures: Arthrodesis considered for chronic, irreducible dislocations 1.
Operative Indications: Recommended for persistent instability or chronic dislocations 1.Special Populations
No Specific Guidelines: Limited evidence addressing pregnancy, pediatrics, or elderly populations directly from provided abstracts 34.Key Recommendations
Perform open reduction and internal fixation for acute CMC joint dislocations to restore joint alignment and function (Evidence: Moderate 2).
Consider arthrodesis as a salvage procedure for chronic, irreducible CMC dislocations to stabilize the joint and prevent further disability (Evidence: Weak 1).
Differentiate mallet thumb from CMC dislocations clinically to guide appropriate treatment approaches (Evidence: Expert opinion 4).References
1 McCarley M, Foreman M. Chronic Carpometacarpal Dislocation of the Thumb: A Case Report and Review of the Literature. JBJS case connector 2018. link
2 Chen VT. Dislocation of carpometacarpal joint of the little finger. Journal of hand surgery (Edinburgh, Scotland) 1987. link
3 Gunther SF. The carpometacarpal joints. The Orthopedic clinics of North America 1984. link
4 Din KM, Meggitt BF. Mallet thumb. The Journal of bone and joint surgery. British volume 1983. link