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Management algorithm for index through small finger carpometacarpal fracture dislocations.
C Büren1, S Gehrmann2, R Kaufmann3
1Department of Trauma and Hand Surgery, University Hospital, Duesseldorf, Germany. carina.bueren@med.uni-duesseldorf.de.
Summary
Carpometacarpal (CMC) fracture dislocations, particularly in the ring and small fingers, are rare but require prompt diagnosis. Surgical intervention is often preferred to restore optimal hand function.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Traumatology
Background:
- Injuries to the carpometacarpal (CMC) joints are infrequent.
- Fracture dislocations most commonly affect the ring and small finger CMC joints.
- Early and accurate diagnosis is crucial for preserving hand function.
Purpose of the Study:
- To review the established diagnostic procedures for CMC joint injuries.
- To explore and contrast various treatment modalities for CMC fracture dislocations.
Main Methods:
- Review of diagnostic protocols for CMC fracture dislocations.
- Comparison of non-operative versus surgical treatment strategies.
- Emphasis on the role of thin-slice CT scans in diagnosis.
Main Results:
- Thin-slice CT scans are recommended when clinical suspicion of CMC dislocation is present.
- Non-operative treatment is seldom indicated for CMC fracture dislocations.
- Open reduction is generally favored for most fracture dislocations, with fixation via K-wires, mini plates, or screws.
Conclusions:
- Carpometacarpal fracture dislocations of the fourth and fifth digits are uncommon and frequently missed.
- Restoring normal hand function is the primary objective of treatment.
- Operative therapy is frequently the most effective treatment approach.
