Simultaneous Dislocation of the Interphalangeal and Carpometacarpal Joints of the Thumb

Introduction

It is rare to encounter cases of simultaneous dislocations of two joints of a finger. We report a case of simultaneous dislocation of the interphalangeal and carpo-metacarpal of an inch with a normal metacarpophalangeal joint. A young engineer of 30 years right-hander laterality was admitted to the emergency after a sports accident, falling on his right hand with a thumb in hyper extension during a football game, complained of pain, Deformity and functional disability of his right thumb. On examination, there was a visible dorsal dislocation of the carpo-metacarpal (CMC) and interphalangeal (IP) joints of the thumb without cutaneous opening or vasculonervous disorder. Radiological examination revealed a pure double dislocation of the CMC and IP joints of the first finger.

Image Article

Under locoregional anesthesia and brightness amplifier control a closed focus reduction supplemented by a double broaching of the two dislocations using Kirschner 12/10 pins was made. Control radiographs confirmed the reduction and absence of associated fracture. Postoperatively, the hand was held in a thumb splint. After six weeks, the patient was seen and the pins were removed under local anesthesia. Functional rehabilitation was started At three months, the joint amplitude balance showed a flexion at 70

• for the CMC and 70
• for the PI, an active extension at 0
• for the CMC and the PI, without pain or residual laxity.

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Figure 3,4 : Double Broaching of The Two Dislocations Using Kirschner 12/10 Pins