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Pure carpo-metacarpal dislocations without any fracture are rare, their volar component is exceptional. Untreated injuries can result in instability and early articular degeneration. We report a 72-year-old female patient who underwent an isolated closed volar dislocation of her fifth finger carpo-metacarpal joint after a fall. The clinical examination showed a 10°-defect in rotation with limited adduction (radial deviation). The X-rays showed a gap between the base of the fourth and the fifth metacarpal bones with volar dislocation of the base of the fifth carpometacarpal joint. The dislocation was successfully treated by closed reduction maintained with two K-wires. Immobilisation of the joint was applied for 6 weeks. At 2 years follow-up evaluation, the patient was pain free with no clinico-radiological evidence of instability and had returned to her previous level of activity., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Metacarpal fractures and dislocations in the fingers are common injuries in children's hands. Most of these can be treated successfully non-operatively, although a subset requires more aggressive treatment. Results following appropriate care in children are generally good. Twenty percent of them need a reduction, need for surgical stabilization is rare. Each injury is presented, including diagnostic, therapeutic principles, pitfalls to prevent and potential complications., (Copyright © 2013. Published by Elsevier SAS.)

Objectives: The authors report clinical and radiological results of carpometacarpal dislocations treated in emergency over a period of 7 years (2002-2009). Mechanisms of injury and diagnosis pitfalls are specified, and treatment options are discussed., Methods: A retrospective study of 100 carpometacarpal dislocations was performed. Most commonly trauma was a punch (56%). In half the cases, lesions were located only within the fifth ray. Carpal or metacarpal fractures were associated in a majority of cases (88%). Surgical treatment was carried out in all cases either by closed reduction and percutaneous pinning (60%), or by open reduction and internal fixation (40%). The mean follow-up was 5 months. Anatomic reduction of dislocation, consolidation and reduction of associated fractures were analysed on the last follow-up x-rays. Evaluation tools were pain score, range of motion and grip strength., Results: Radiological criteria were satisfactory in 68% of cases. Non-satisfactory X ray criteria were mainly associated with closed reduction and percutaneous pinning. At final follow up, 81% of the patients were pain-free and had recovered complete range of motion. In 16% of patients pain was only found during grip strength test., Conclusions: Carpometacarpal luxations are not as rare as suggested by literature. Early diagnosis and treatment are essential for the prognosis. Increasing indications of a scan enable better analysis by identifying all injuries. Open reduction by which allows the treatment of all associated injuries must be promoted., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

We report a case of volar dislocation of four ulnar carpometacarpals. It's a very rare injury, especially as it affects all long fingers, it is volar and has no fractures. The treatment consisted in open-reduction with pinning carpometacarpal according to intraoperative stability. No complications was noted. The follow-up was a radiological evaluation (pain, strength, mobility) between 6th week and 6th month. The recovery was complete at 6 months without pain. We believe that open reduction allows carpometacarpal osteosynthesis to be the less invasive as possible, depending on the stability visualized and thus can reduce stiffness and residual pain., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

We report a case of a carpometacarpal joint dislocation of the thumb associated with trapezium and Bennett's fractures. This combined injury pattern appears to be very rare. To our knowledge, no such case was found in the literature. The patient had open reduction internal fixation with pins and screws, with good functional outcome., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

The authors report an unusual case of multiple carpometacarpal joint dislocations of the ulnar four fingers, treated by closed reduction and fixation with percutaneous Kirschner-wires. A plaster splint with the wrist in neutral position was applied for six weeks. Active physiotherapy of the fingers was started from four weeks after surgery, with a satisfactory result.

Objectives: Carpometacarpal dislocation of the little finger is a rare and little known injury. We performed a 10 years retrospective study of all the cases in our unit in order to improve comprehension and treatment of this disease., Methods: Thirty-one patients were included in this study. All the dislocations were dorsal with 5 isolated fifth carpometacarpal dislocations, 6 fracture-dislocations of the base of the fifth metacarpal, 19 fourth and fifth dislocations and one third-fourth-fifth dislocation. Diagnosis of the injury was made early in only 19 patients. 30 had surgical management, 28 with percutaneous K-wires, and 2 through a metacarpalhamate arthrodesis., Results: Twenty-six patients were available for follow-up at an average of 6 months and 5 patients were lost for follow-up. Twenty-five patients had satisfactory results. A reflex sympathetic dystrophy delayed the recovery for one patient. There was no recurrence of dislocation at follow-up. There was no complication necessitating revision surgery., Conclusion: Diagnosis of carpometacarpal dislocation of the little finger can be performed with conventional radiographic examination; computer-tomography is helpful to confirm an associated fracture of the carpus. The goal of treatment is early reduction and fixation of the metacarpal. There is no recommendation for operative technique based on scientific evaluation. Early diagnosis is the key to success.

Anterior dislocations of the second and third carpometacarpal joints are extremely rare. The authors report a case of an anterior dislocation of the bases of the second and third metacarpals of the right hand treated by closed reduction and percutaneous wiring. The result was excellent and the authors think that this type of carpometacarpal dislocation does not need open reduction.

A case of simultaneous dorsal dislocation of the metacarpophalangeal and carpometacarpal joints in the little finger is presented. The patient required an open reduction of the metacarpophalangeal joint, the carpometacarpal joint was reduced simultaneously. Thirty month post-operatively there was no subluxation of either joint.