Conservative Treatment of Complete Dislocation of the Thumb Metacarpal in a Hypermobile Patient

Authors

Department of Orthopedics and Traumatology, Near East University Medical Faculty, Nicosia, Cyprus, Turkey

Abstract

Simultaneous dislocation of the thumb carpometacarpal and metacarpophalangeal joints is an uncommon injury. Stability is the most important
factor in the decision of treatment in these rare injuries. The treatment methods range from closed reduction and maintaining reduction with
cast or percutaneous k‑wires to complex reconstruction surgeries. In this paper, a case of 28-year-old female with complete dislocation of
the left thumb metacarpal has been reported. She was treated with closed reduction and cast immobilization with excellent result. Treatment
decision should be based on postreduction stability in complete dislocation of thumb metacarpal; cast immobilization is a management option
in case of stable reduction.

Keywords


1. Moore JR, Webb CA Jr., Thompson RC. A complete dislocation of the thumb metacarpal. J Hand Surg Am 1978;3:547‑9.

2. Ibrahim S, Noor MA. Simultaneous dislocations of the carpometacarpal and metacarpophalangeal joints of the thumb. Injury 1993;24:343‑4.

3. Drosos GI, Kayias EH, Tsioros K. “Floating thumb metacarpal” or complete dislocation of the thumb metacarpal: A case report and review of the literature. Injury 2004;35:545‑8.

4. Afshar AR, Mirzatoloei F, Abdi‑Rad I. Concurrent dislocations of carpometacarpal and metacarpophalangeal joints of the thumb. Arch Iran Med 2005;8:221‑2.

5. Marcotte AL, Trzeciak MA. Nonoperative treatment for a double dislocation of the thumb metacarpal: A case report. Arch Orthop Trauma Surg 2008;128:281‑4.

6. Khan H, Darcy P, Magnussen P. Simultaneous volar dislocations of carpometacarpal and metacarpophalangeal joints of the thumb. J Orthop Case Rep 2012;2:8‑11.

7. Beighton P, Horan F. Orthopaedic aspects of the Ehlers‑Danlos syndrome. J Bone Joint Surg Br 1969;51:444‑53.

8. Singh D, Krishna LG, Dhaka S, Kumar S, Arora S. Rare double fracture‑dislocation of the thumb: A case report and review of the literature. Chin J Traumatol 2013;16:240‑2.

9. Shih KS, Tsai WF, Wu CJ, Mudgal C. Simultaneous dislocation of the carpometacarpal and metacarpophalangeal joints of the thumb in a motorcyclist. J Formos Med Assoc 2006;105:670‑3.

10. Messaoudi T, Errhaimini M, Ghoubach M, Chafik R, Madhar M, Elhaoury H, et al. Floating thumb metacarpal in a motorcyclist: A case report. Chir Main 2015;34:91‑3.

11. Leiber‑Wackenheim F, David E, Tran Van F, Havet E, Vernois J, Mertl P, et al. Floating first metacarpal with recurrent trapeziometacarpal dislocation in a subject with hyperlaxity. Rev Chir Orthop Reparatrice Appar Mot 2007;93:725‑9.