[Fractures and luxations of the thumb]

The integrity of the first carpometacarpal column determines the mobility of the thumb in space and thus opposition, a fundamental function of the human hand. Fractures and dislocations of this architecture can jeopardize its function. Joint lesions lead to instability or incongruity and subsequent post-traumatic stiffening arthrosis. Diaphyseal fractures can put out of axis or lead to abnormal rotation which impair the flexion and overall function of the thumb. Great attention should therefore be given to the anatomical reconstruction of these lesions. Open, unstable joint or periosteal fractures should be surgically reduced and a rigid fixation should be used. Dislocations require emergency treatment and in case of postreduction instability should be immobilized.