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Recurrent posttraumatic trapeziometacarpal joint dislocation in a child: A case report
Julien Gaillard1, Franck Fitoussi1
1Orthopedic and Reconstructive Pediatric Surgery Department, Trousseau Hospital, Paris 6 University, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France.
Insights
Recurrent thumb trapeziometacarpal joint dislocation is rare in children. This case highlights the challenges in managing this injury, emphasizing the need for anatomical restoration, though surgical approaches remain debated.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Hand Injuries
Background:
- Traumatic trapeziometacarpal (TMC) joint dislocation is a rare hand injury, accounting for less than 1% of all cases.
- Optimal treatment strategies for TMC joint dislocations, particularly in pediatric populations, are not well-established and remain a subject of debate.
Observation:
- This report details a unique case of recurrent posttraumatic TMC joint dislocation in an eight-year-old girl.
- The patient experienced acute dislocations that progressed to a chronic state, a presentation believed to be novel in the English medical literature.
Findings:
- Restoring TMC joint anatomy and biomechanics is crucial for effective treatment, often necessitating surgical intervention.
- While acute TMC joint dislocations generally have a favorable prognosis, the efficacy of open surgery and ligament reconstruction in children is still under investigation.
Implications:
- This case underscores the complexities of managing recurrent TMC joint dislocations in pediatric patients.
- Further research is needed to clarify the optimal surgical techniques and long-term outcomes for pediatric TMC joint injuries.
Abstract:
Traumatic trapeziometacarpal joint dislocation of the thumb accounts for less than 1% of all hand injuries. This injury is even less common in children. Optimal treatment strategies for this injury are still the subject of debate for both children and adults. We report a case of recurrent posttraumatic trapeziometacarpal joint dislocation in an eight-year-old girl. We believe our case is the first report of recurrent acute dislocation leading to chronic dislocation in the English medical literature. Restoring the anatomy and biomechanics of the trapeziometacarpal joint is essential when treating these injuries; for this reason, surgical treatment is usually indicated. Overall, the prognosis of trapeziometacarpal dislocation treated acutely is favorable and stable over time. However, the role of open surgery and ligament reconstruction remains controversial, especially in children.
