Management of Rare Case of Missed Fracture‐Dislocation of Second and Third CMC Joints: A Missed Injury Case Report

ABSTRACT Isolated fracture‐dislocation of the second and third carpometacarpal joints (CMC) is very rare, and it is commonly misdiagnosed. Injury to this joint is usually associated with high‐energy trauma, like a motor vehicle accident. Despite correct diagnosis, optimal treatment for these injurie...

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Main Authors: Yeshi Dorji, Ugyen Thrinley
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Clinical Case Reports
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Online Access:https://doi.org/10.1002/ccr3.70239
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author Yeshi Dorji
Ugyen Thrinley
author_facet Yeshi Dorji
Ugyen Thrinley
author_sort Yeshi Dorji
collection DOAJ
description ABSTRACT Isolated fracture‐dislocation of the second and third carpometacarpal joints (CMC) is very rare, and it is commonly misdiagnosed. Injury to this joint is usually associated with high‐energy trauma, like a motor vehicle accident. Despite correct diagnosis, optimal treatment for these injuries is still controversial. We present a 31‐year‐old male patient with a history of one‐month‐old injury to his right hand following a motorcycle accident. Initially, he was treated by one of the orthopedic surgeons elsewhere and misdiagnosed as having blunt trauma to the hand. On presentation, he complained of persistent pain and swelling with deformity of the right hand following the initial treatment he received. Apparently, only AP and Oblique radiographs of the hand were taken. Treatment On clinico‐radiological evaluation, he was found to have a fracture dislocation of 2nd and 3rd CMC joints. He was managed with open reduction and percutaneous pinning with K‐wires. Since the majority of these injuries have a higher chance of misdiagnosis, we recommend careful clinical examination, a high index of suspicion in cases of high‐energy injury, and taking all three standard view radiographs of the hand.
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spelling doaj-art-1206f465a3a24bb7bb5e8b1fa4c3fec22025-08-20T02:15:51ZengWileyClinical Case Reports2050-09042025-02-01132n/an/a10.1002/ccr3.70239Management of Rare Case of Missed Fracture‐Dislocation of Second and Third CMC Joints: A Missed Injury Case ReportYeshi Dorji0Ugyen Thrinley1Department of Orthopedic, Military Hospital Army Medical Service Thimphu BhutanDepartment of Orthopedic Jigme Dorji Wangchuck National Referral Hospital Thimphu BhutanABSTRACT Isolated fracture‐dislocation of the second and third carpometacarpal joints (CMC) is very rare, and it is commonly misdiagnosed. Injury to this joint is usually associated with high‐energy trauma, like a motor vehicle accident. Despite correct diagnosis, optimal treatment for these injuries is still controversial. We present a 31‐year‐old male patient with a history of one‐month‐old injury to his right hand following a motorcycle accident. Initially, he was treated by one of the orthopedic surgeons elsewhere and misdiagnosed as having blunt trauma to the hand. On presentation, he complained of persistent pain and swelling with deformity of the right hand following the initial treatment he received. Apparently, only AP and Oblique radiographs of the hand were taken. Treatment On clinico‐radiological evaluation, he was found to have a fracture dislocation of 2nd and 3rd CMC joints. He was managed with open reduction and percutaneous pinning with K‐wires. Since the majority of these injuries have a higher chance of misdiagnosis, we recommend careful clinical examination, a high index of suspicion in cases of high‐energy injury, and taking all three standard view radiographs of the hand.https://doi.org/10.1002/ccr3.70239carpometacarpal dislocationisolatedmisdiagnosisopen reductionrare
spellingShingle Yeshi Dorji
Ugyen Thrinley
Management of Rare Case of Missed Fracture‐Dislocation of Second and Third CMC Joints: A Missed Injury Case Report
Clinical Case Reports
carpometacarpal dislocation
isolated
misdiagnosis
open reduction
rare
title Management of Rare Case of Missed Fracture‐Dislocation of Second and Third CMC Joints: A Missed Injury Case Report
title_full Management of Rare Case of Missed Fracture‐Dislocation of Second and Third CMC Joints: A Missed Injury Case Report
title_fullStr Management of Rare Case of Missed Fracture‐Dislocation of Second and Third CMC Joints: A Missed Injury Case Report
title_full_unstemmed Management of Rare Case of Missed Fracture‐Dislocation of Second and Third CMC Joints: A Missed Injury Case Report
title_short Management of Rare Case of Missed Fracture‐Dislocation of Second and Third CMC Joints: A Missed Injury Case Report
title_sort management of rare case of missed fracture dislocation of second and third cmc joints a missed injury case report
topic carpometacarpal dislocation
isolated
misdiagnosis
open reduction
rare
url https://doi.org/10.1002/ccr3.70239
work_keys_str_mv AT yeshidorji managementofrarecaseofmissedfracturedislocationofsecondandthirdcmcjointsamissedinjurycasereport
AT ugyenthrinley managementofrarecaseofmissedfracturedislocationofsecondandthirdcmcjointsamissedinjurycasereport