Early Recognition and Treatment of Carpometacarpal Fractures and Dislocations

Carpometacarpal (CMC) injuries can easily be missed in more than half of the cases. Early diagnosis is crucial for treatment. Although the clinical aspect can lead the treating physician to suspect that anything is going wrong, appropriate radiographs, especially in the lateral view, are crucial for the diagnosis. The most common CMC fracture dislocations affects the 4 (th) and 5 (th) joints. Treatment will depend on the type of injury and on the degree of joint involvement. Reduction and fixation are usually required. When only one ray is affected, usually the 5 (th) , closed reduction and fixation with Kirschner wires can be performed. In complex cases, open reduction and fixation are required, with Kirschner wires being the most commonly used materials. After the hardware removal, rehabilitation can be intensified. If an appropriate reduction has been achieved, satisfactory functional and radiological outcomes are expected.