2016 Volume 41 Issue 3 Pages 199-203
INTRODUCTION: Fracture dislocation of the 4th and 5th carpometacarpal joints (CM joints) is a relatively rare injury, which occurs when longitudinal pressure is applied to the metacarpal bone.
STUDY SUBJECTS and METHODS: The study subjects were three patients with fracture dislocation of the 4th and 5th CM joints who received treatment at our hospital during the 5 year period from 2010 to 2014. All the three patients were treated by surgery. For fracture of the base of the 5th metacarpal, osteosynthesis with pinning was performed. For hamate body fracture, screw fixation with pinning was performed. For hamate body fracture associated with capitate fracture and fracture of the base of the 3rd metacarpal, pinning fixation was performed after reduction of each fracture.
RESULTS: In all 3 patients, good fracture reduction was achieved, with consequent bone fusion. Thus, good clinical results were obtained.
DISCUSSION: Radiographic images taken in two directions alone are insufficient for making an accurate diagnosis of fracture dislocation of the 4th and 5th CM joints. When fracture dislocation of the 4th and 5th CM joints is suspected, it is necessary to examine radiographic images taken in 4 directions, including images obtained at 30-degrees internal rotation and 60-degrees external rotation. Computed tomography (CT) is also useful.
CONCLUSIONS: For fracture dislocation of the 4th and 5th CM joints diagnosed accurately, good treatment outcomes can be achieved by fracture reduction and fixation.
