An Unusual Appearance of Base of First Metacarpal Fracture: A Case Report

We present the case of an unusual base of the first metacarpal fracture. The presentation and radiological images are provided to demonstrate a first metacarpal base fracture but with a concurrent appearance at first glance of a trapeziectomy mimic on plain radiographs. The CT scan however demonstrates the true nature of the injury - a comminuted fracture with carpometacarpal subluxation. The radiological and clinical findings presented a diagnostic and therapeutic dilemma. We elected to not intervene surgically with a good resulting clinical outcome, reminding us of the need to treat the patient and not their radiographic images.