Current Concepts: Lesser Digit Carpometacarpal Joint Fracture-Dislocations

Carpometacarpal fractures and dislocations are commonly unrecognized injuries. Treating physicians need to maintain a high index of suspicion regarding this particular injury as delay in diagnosis and treatment can lead to a suboptimal outcome. Mechanism of injury often entails high-energy trauma or an axial blow to a closed fist. Thorough physical examination and adequate imaging are necessary during initial evaluation. Closed management and immobilization can be considered if the injury is recognized early; however, surgical reduction and stabilization are more commonly warranted. This article provides a comprehensive current concepts review on the evaluation and management of acute and subacute lesser digit carpometacarpal joint injuries, highlighting the pertinent anatomy, proper imaging, and treatment options. Both nonsurgical and surgical treatments are discussed including the various percutaneous and open reduction internal fixation options.