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Post-traumatic wind swept deformity: five volar carpometacarpal dislocations.

Prajwal P Mane¹, Anil K Bhat¹, Ashwath Acharya¹

¹Orthopaedics, Kasturba Medical College, Manipal, Karnataka, India.

BMJ Case Reports

|May 10, 2019

Summary

Carpometacarpal (CMC) joint dislocations are rare hand injuries, often missed. This case highlights a neglected volar CMC dislocation causing a windswept hand deformity, emphasizing the need for high suspicion in diagnosis.

Keywords:

musculoskeletal and joint disorders orthopaedics radiology trauma

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Area of Science:

Orthopedic Surgery
Hand Surgery
Radiology

Background:

Carpometacarpal (CMC) joint dislocations are uncommon hand injuries, representing less than 1% of all hand trauma.
These injuries are frequently overlooked due to their rarity and potential for subtle presentation.
CMC dislocations can occur dorsally or volarly, with dorsal dislocations being more prevalent.

Observation:

Volar CMC joint dislocations are exceptionally rare and demand a high index of suspicion for accurate diagnosis.
A case is presented involving a 36-year-old female with a neglected post-traumatic volar dislocation affecting all five CMC joints.
The neglected dislocation resulted in a characteristic "windswept" deformity of the hand.

Findings:

The study focuses on the diagnostic challenges and clinical presentation of rare volar CMC joint dislocations.
Neglected dislocations can lead to significant functional impairment and characteristic deformities.
Early and accurate diagnosis is crucial to prevent long-term complications.

Implications:

Highlights the importance of considering rare injuries like volar CMC dislocations in hand trauma evaluations.
Emphasizes the need for increased clinical suspicion to avoid missed diagnoses and delayed treatment.
Underscores the potential for severe functional deficits and deformities if volar CMC dislocations are neglected.