Simultaneous Fifth Carpometacarpal Joint Dislocation and Fourth Metacarpal Neck Fracture: A Conservative Treated Case With a Functional Metacarpal Splint

Simultaneous carpometacarpal joint dislocation and fractures of adjacent carpal bones are rare orthopedic injuries. With this case, we aimed to discuss the effectiveness and ergonomics of the functional metacarpal splint in carpometacarpal joint dislocations and metacarpal neck fractures without surgery. A 27-year-old right-hand dominant male applied to the emergency department after a punch on a wall with his right fist. Pain, swelling, and deformity were evident without neurovascular injury. The radiographs showed simultaneous fifth carpometacarpal joint dislocation and fracture of the neck of the fourth metacarpal bone. We performed closed reduction with longitudinal traction and applied a functional metacarpal splint. We followed up with the patient regularly, and on the fourth week, we removed the splint and began a range of motion exercises. On the sixth week, we began muscle strengthening exercises, and we reached full range of motion with fair muscle strength on the eighth week of the follow-up without any deformity. In this case, prompt diagnosis, longitudinal traction, closed reduction with manual dorsal manipulation, and functional metacarpal splinting were adequate. We achieved a full range of motion without the need to immobilize the wrist or metacarpophalangeal joints or undergo surgery after proper immobilization with a functional metacarpal splint.