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Floating thumb with double dislocation of carpometacarpal and metacarpo-phalangeal joints
Aysha Rajeev1, Soliman Noureldin1, David Graham1
1Department of Trauma and Orthopaedics, Queen Elizabeth Hopsital, Gateshead NE9 6SX, UK.
Introduction:
Double dislocations of carpometacarpal and metacarpo-phanlageal joints are rare. We report an unusual case of simultaneous dislocation of both CMC and MCP joints in the thumb.
Presentation Of Case:
A 31 year old male was admitted following a road traffic accident. He was complaining of pain and deformity of right thumb. The X-ray examination revealed simultaneous dislocation of both CMC and MCP joints. He underwent closed manipulative reduction and percutaneous K wire fixation. The wires were removed after six weeks. After a course of physiotherapy he regained full range of pain free movements.
Discussion:
The incidence of simultaneous dislocation of both CMC and MCP joints in thumb are associated with high energy injuries. The options of treatment are conservative with cast immobilisation and serial X-rays or operative including closed manipulative reduction and K wire fixation or open reduction and internal fixation.
Conclusion:
The option of treating this rare injury with closed manipulative reduction and percutaneous K wiring gives excellent and predictable results.
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