Current Concepts: Lesser Digit Carpometacarpal Joint Fracture-Dislocations

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Hand Surgery

Background:

• Carpometacarpal (CMC) fractures and dislocations are frequently unrecognized injuries.
• Delayed diagnosis and treatment of CMC injuries can result in poor patient outcomes.
• High-energy trauma or a direct blow to a closed fist commonly causes these injuries.

Purpose of the Study:

• To provide a comprehensive review of current concepts in the evaluation and management of acute and subacute lesser digit CMC joint injuries.
• To highlight key anatomical structures, appropriate imaging techniques, and available treatment strategies for CMC joint injuries.

Main Methods:

• Review of current literature on lesser digit carpometacarpal joint injuries.
• Discussion of diagnostic approaches including physical examination and imaging.
• Analysis of both non-surgical and surgical management options.

Main Results:

• Early recognition and intervention are vital for managing CMC fractures and dislocations.
• While closed management may be suitable for early, recognized injuries, surgical reduction and stabilization are frequently required.
• Various percutaneous and open reduction internal fixation techniques are available for surgical management.

Conclusions:

• A high index of suspicion is necessary for diagnosing CMC injuries.
• Comprehensive evaluation involving thorough physical examination and appropriate imaging is essential.
• Treatment decisions for lesser digit CMC injuries should consider the timing of presentation and injury severity, with surgical intervention often being the preferred approach for optimal functional recovery.