Combined fourth and fifth metacarpal fracture and fifth carpometacarpal joint dislocation

Three cases of hamato-metacarpal fracture-dislocation with fracture of the shaft or base of the fourth metacarpal and dorsal dislocation of the fifth metacarpal are described. In one case this was associated with coronal fracture of the hamate. An oblique radiograph of the hand with the forearm pronated 15 degrees and 45 degrees provided a good view of the extent of the fourth and fifth carpometacarpal injury. Treatment with open reduction and internal fixation achieves good clinical results.