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Multiple carpo-metacarpal dislocations.

J D de Beer1, S Maloon, P Anderson

  • 1Hand Surgery Unit, Groote Schuur Hospital, Cape Town, South Africa.

Journal of Hand Surgery (Edinburgh, Scotland)
|February 1, 1989
PubMed
Summary
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Successful treatment of closed multiple carpo-metacarpal dislocations requires prompt intervention. Closed manipulation within two days, followed by Kirschner wire fixation and casting, ensures optimal outcomes for this unstable injury.

Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Hand Surgery

Background:

  • Multiple carpo-metacarpal dislocations are complex hand injuries.
  • These injuries often present with significant instability.
  • Timely diagnosis and management are crucial for functional recovery.

Purpose of the Study:

  • To evaluate the efficacy of closed manipulation for carpo-metacarpal dislocations.
  • To determine the optimal timing for intervention.
  • To recommend management strategies for unstable carpo-metacarpal dislocations.

Main Methods:

  • Review of ten patients with closed multiple carpo-metacarpal dislocations.
  • Assessment of closed manipulation success based on timing.
  • Evaluation of immobilization techniques including plaster cast and Kirschner wire fixation.

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Main Results:

  • Closed manipulation was successful when performed within two days of injury.
  • Percutaneous Kirschner wire fixation supplemented plaster cast immobilization.
  • This approach effectively maintained reduction in unstable dislocations.

Conclusions:

  • Early closed manipulation within 48 hours is effective for carpo-metacarpal dislocations.
  • Surgical fixation with Kirschner wires is recommended for stability.
  • Prompt and appropriate treatment leads to a good prognosis.