Late Presentation of Palmar Dislocation of the Fifth Metacarpal Bone: Review of the Literature, Treatment Algorithm, and Case Report

INTRODUCTION: Isolated palmar carpometacarpal dislocation of the small finger is infrequent, this injury often goes unnoticed in the evaluation at the emergency room, for which physical evaluation and X-ray findings can avoid missing this diagnosis. We describe a case report and propose a treatment algorithm for isolated dislocations of the carpometacarpal joint of the fifth finger to the palmar that is not diagnosed and treated early, using this algorithm, the surgeon will have a vision of the probable best treatment option. CASE PRESENTATION: A 50-year-old with late presentation of palmar dislocation of the fifth metacarpal bone, the diagnosis that went unnoticed in the initial emergency assessment. The patient was taken to an open reduction and internal fixation with an internal brace fixed at the base of the fifth metacarpal, the base of the fourth metacarpal and the hamate, and the fifth metacarpal was fixed to the fourth metacarpal with a Kirschner wire placed transversely to the axis of the metacarpal. CONCLUSION: Physical evaluation and X-ray findings, physicians can avoid missing isolated palmar carpometacarpal dislocation of the small finger. Using this algorithm according to the temporality of the injury, direction of the dislocation, and stability of the joint, the surgeon will have a vision of the probable best treatment option.