Volar Dislocation of Second, Third and Fourth Carpometacarpal Joints in Association with a Bennet's Fracture of the Thumb Carpo-Metacarpal Dislocation: A Case Report

Injuries of the carpometacarpal joints of the long fingers are infrequent and go often unnoticed if a thorough clinical exploration and complete radiological assessment is not carried out. The overall frequency of carpometacarpal joints injuries is of 1-2% among trauma of the wrist and the carpus. These are normally secondary to high energy trauma (such as a car or a motorbike accidents). Among these kinds of injuries, the volar dislocation of the metacarpals is much less frequent than the dorsal dislocation, being even rarer the cases in which the three middle metacarpals are involved. In this case report, we present a case of volar dislocation of the middle three carpometacarpal joints in association with a Bennet's fracture of the thumb in a 30-year-old male. He was treated in the operating room with reduction and stabilization using Kirschner wires, which allowed a satisfactory recovery of the mobility of the fingers eight weeks after the intervention. It is important to produce an admission diagnosis of this kind of injuries to be able to treat them immediately. Treatment must be performed quickly to reduce and stabilize the dislocation, since this will avoid the vasculo-nervous compression or the edema which increases cutaneous suffering and the risk of complications.