Four Cases of Fracture-Dislocation of the 4th and 5th Carpometacarpal Joints

Abstract

Carpometacarpal dislocation other than thumb is uncommon. Four patients with dorsal fracture dislocations of the fourth and fifth carpometacarpal joints were treated. Direct trauma, such as from a fall or blow was the principal mode of injury. Two cases were first diagnosed as fractures of the fourth metacarpal by first aid doctors. Three cases had fractures of the fourth metacarpal base, with dorsal displacement of the distal fragment that accompanied a fragment of hamate fracture and dorsal dislocation of the fifth metacarpal. The other case only had dorsal and proximal dislocation of the fourth metacarpal with a fragment of hamate fracture. Three cases were treated operatively and one case conservatively.