Carpometacarpal Fracture-Dislocations: A Retrospective Review of Injury Characteristics and Radiographic Outcomes

Area of Science:

• Orthopedic surgery
• Hand surgery
• Radiographic imaging

Background:

• Carpometacarpal (CMC) joint injuries require evaluation of patient demographics and treatment outcomes.
• A 10-year retrospective review was conducted to assess CMC injuries.

Purpose of the Study:

• To evaluate the demographics of patients with CMC injuries.
• To assess the early radiographic treatment outcomes for CMC injuries.

Main Methods:

• Retrospective review of patients with CMC injuries (digits 2-5) from 2005-2015.
• Data collected included demographics, injury mechanisms, associated injuries, treatments, and complications.
• Radiographic evaluation using a developed grading system for reduction adequacy.

Main Results:

• Eighty patients were included; fist impact was the most common injury mechanism.
• Fourth and fifth CMC joint injuries were most frequent, often with metacarpal base and distal carpal row fractures.
• Closed reduction and percutaneous pinning resulted in a higher rate of concentric reduction.

Conclusions:

• CMC injuries can stem from both low and high-energy mechanisms.
• Metacarpal base and distal carpal row fractures are common associated injuries.
• Early diagnosis and closed reduction with percutaneous pinning yield favorable radiographic outcomes; delayed diagnosis leads to poorer results.