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Isolated dislocation of the second metacarpal at both ends
I K Dhammi1, A K Jain, A Arora
1Department of Orthopaedics, University College of Medical Sciences, Delhi, India.
Journal of Orthopaedic Trauma
|March 10, 2001
Summary
This case report details the first instance of a second metacarpal dislocation at both its proximal and distal ends. Surgical intervention involved open reduction and K-wire fixation, followed by arthrodesis, with functional outcomes assessed at six months.
Area of Science:
- Orthopedics
- Hand Surgery
- Traumatology
Background:
- The second metacarpal is crucial for hand function.
- Injuries to the metacarpals can significantly impair hand dexterity.
- Dual-end dislocations of the second metacarpal are exceptionally rare.
Observation:
- A 34-year-old female presented with pain, swelling, and deformity six weeks after a fall.
- Radiographs revealed a simultaneous volar dislocation of the second metacarpal head and a dorsal dislocation of its base.
- The injury mechanism involved hyperextension at the metacarpophalangeal joint followed by hyperflexion of the wrist.
Findings:
- Open reduction and K-wire fixation of the metacarpophalangeal joint were performed.
- Arthrodesis of the carpometacarpal joint was necessary to stabilize the base.
- Six-month follow-up showed restricted metacarpophalangeal joint flexion (0-50 degrees) but preserved interphalangeal joint motion.
Implications:
- This case highlights a novel pattern of second metacarpal dislocation, expanding the understanding of hand trauma.
- Successful surgical management can restore stability, though functional deficits may persist.
- Further research into similar injuries is warranted to refine treatment strategies.