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Related Concept Videos

Functional Classification of Joints01:09

Functional Classification of Joints

Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses  or amphiarthroses, whereas all synovial joints are classified as diarthroses.
Synarthrosis
An immobile...

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Complex, Multidirectional Carpometacarpal Dislocations: A Case Report.

Anil Dhal1, Saket Prakash, Pulkit Kalra

  • 1Department of Orthopaedics, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India.

JBJS Case Connector
|September 10, 2020
PubMed
Summary
This summary is machine-generated.

A rare combined convergent-divergent carpometacarpal (CMC) fracture dislocation involving the median nerve was treated surgically. This case highlights the importance of advanced imaging for diagnosing complex CMC dislocations after high-energy trauma.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Hand Surgery

Background:

  • Carpometacarpal (CMC) joint dislocations are uncommon injuries.
  • High-energy trauma can result in complex fracture dislocations of the CMC joints.

Observation:

  • A young adult sustained a rare combined convergent-divergent CMC fracture dislocation after a motorbike accident.
  • Radiographs demonstrated volar dislocation of the second and fifth metacarpals and dorsal dislocation of the third and fourth metacarpals.
  • The bases of the second and fifth metacarpals converged in the coronal plane, with associated median nerve involvement.

Findings:

  • Surgical intervention involving open reduction and internal fixation was performed.
  • Carpal tunnel release was necessary due to median nerve involvement.

Implications:

  • Combined convergent-divergent CMC fracture dislocation should be considered in the differential diagnosis of CMC dislocations.
  • Advanced imaging, including 3D CT reconstructions and specific radiographic views (metacarpal cascade line, radial/ulnar lateral views), is crucial for accurate diagnosis.
  • Prompt surgical management is essential for favorable outcomes in these complex injuries.