Open complete dislocation of trapezium with a vertically split fracture: a case report.

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Hand Surgery

Background:

• Open complete dislocation of the trapezium is exceptionally rare.
• A vertically split fracture associated with this dislocation further increases its rarity.
• Such injuries are typically caused by significant direct force to the carpal area.

Purpose of the Study:

• To report a rare case of open complete trapezium dislocation with a vertical split fracture.
• To discuss the management and outcome of this unique injury.
• To contribute to the limited literature on trapezium fracture-dislocations.

Main Methods:

• A 14-year-old male patient with a history of severe hand trauma was evaluated.
• The injury involved an open complete dislocation and vertical split of the trapezium.
• Open reduction and internal fixation with K-wires were performed under general anesthesia.

Main Results:

• The patient underwent surgical repair for the complex trapezium fracture-dislocation.
• One-year follow-up revealed some functional deficit in thumb opposition.
• Despite the deficit, the patient reported satisfaction with the outcome for his non-dominant hand.

Conclusions:

• Open reduction and K-wire fixation can be a viable treatment for open complete trapezium dislocation with fracture.
• While functional deficits may persist, patient satisfaction can be achieved, especially in non-dominant hands.
• This case underscores the importance of reporting rare traumatic hand injuries to expand clinical knowledge.