Association of fracture of trapezium with Bennett'sfracture is very rare and makes reduction and stabilisation more difficult. We are reporting a rare case of Bennett's fracture with fracture of the trapezium ...Association of fracture of trapezium with Bennett'sfracture is very rare and makes reduction and stabilisation more difficult. We are reporting a rare case of Bennett's fracture with fracture of the trapezium and subluxation of the carpo-metacarpal joint(CMC) joint. The patient was a 47-year-old school teacher who fell from his motorbike on his outstretched right dominant hand. Radiographs and computed tomography showed fracture of the trapezium with subluxation of the CMC joint, associated with Bennett's fracture. Open reduction and internal fixation was carried out. Trapezium was reduced first and secured with a 2 mm diameter screw. Bennett's fracture was then reduced and fixed with two per-cutaneously placed Kirchner's wires. CMC was stabilised with percutaneous Kirchner's wires. Latest follow up at 12 mo showed a healed fracture with good reduction of the CMC joint. Clinically patient had no pain and normal extension, abduction and opposition of the thumb. QuickD ASH score was 3.9/100. Thus, fracture of trapezium associated with a Bennett's fracture is a rare injury and if ignored it may lead to poor results. This injury is more challenging to manage than an isolated Bennett's fracture as anatomical reduction of the trapezium with reduction of the first CMC is needed. Fracture of the trapezium should be fixed first as this will provide a stable base for reduction of the Bennett's fracture.展开更多
Carpo-metacarpal dislocations are rare traumatic injuries resulting from violent trauma;they are mostly observed in young subjects. The spatular form is often accompanied by metacarpal fractures. We report a clinical ...Carpo-metacarpal dislocations are rare traumatic injuries resulting from violent trauma;they are mostly observed in young subjects. The spatular form is often accompanied by metacarpal fractures. We report a clinical case of complete dorsal carpo-metacarpal spatular dislocation. This was a 34-year-old patient, admitted for a closed trauma of the right hand, in whom the clinical examination noted edema of the hand. The radiological workup showed a complete dorsal spatular dislocation associated with a fracture of the base of the 2nd metacarpal. The reduction of these lesions in closed focus followed by stabilization by metacarpal broaching associated with an intermetacarpal transverse broach was done under scopic control in emergency. Functional rehabilitation was started in the 3rd week. The broaches were ablated at the 6th week. The functional result at 3 months was satisfying with good muscle strength. Resumption of work was effective at 8 weeks. Carpo-metacarpal dislocations are rare injuries, often unrecognized, especially in polytrauma patients, and have a good functional prognosis if they are managed correctly in an emergency.展开更多
Carpo-metacarpal dislocations are rare hand injuries. They are misdiagnosed due to their non-specific clinical signs. The authors report on their experience in the management of carpometacarpal dislocations in a speci...Carpo-metacarpal dislocations are rare hand injuries. They are misdiagnosed due to their non-specific clinical signs. The authors report on their experience in the management of carpometacarpal dislocations in a specialized hand surgery center. Our study included patients received and treated in the department for a carpometacarpal dislocation. Dislocation fractures of Bennett and Rolando were excluded. The postoperative functional evaluation took place after 18 months by the DASH score. Twelve patients participated: one case of neuro-algodystrophy and one pin infection. The mean DASH functional outcome score was 1.10 at 18 months. Since carpometacarpal dislocations are rare and easily misdiagnosed, the surgeon should assume the possibility of them in patients with high-energy trauma, and imaging studies should be carefully evaluated. Pinning is an effective treatment option that provides good long-term functional results.展开更多
文摘Association of fracture of trapezium with Bennett'sfracture is very rare and makes reduction and stabilisation more difficult. We are reporting a rare case of Bennett's fracture with fracture of the trapezium and subluxation of the carpo-metacarpal joint(CMC) joint. The patient was a 47-year-old school teacher who fell from his motorbike on his outstretched right dominant hand. Radiographs and computed tomography showed fracture of the trapezium with subluxation of the CMC joint, associated with Bennett's fracture. Open reduction and internal fixation was carried out. Trapezium was reduced first and secured with a 2 mm diameter screw. Bennett's fracture was then reduced and fixed with two per-cutaneously placed Kirchner's wires. CMC was stabilised with percutaneous Kirchner's wires. Latest follow up at 12 mo showed a healed fracture with good reduction of the CMC joint. Clinically patient had no pain and normal extension, abduction and opposition of the thumb. QuickD ASH score was 3.9/100. Thus, fracture of trapezium associated with a Bennett's fracture is a rare injury and if ignored it may lead to poor results. This injury is more challenging to manage than an isolated Bennett's fracture as anatomical reduction of the trapezium with reduction of the first CMC is needed. Fracture of the trapezium should be fixed first as this will provide a stable base for reduction of the Bennett's fracture.
文摘Carpo-metacarpal dislocations are rare traumatic injuries resulting from violent trauma;they are mostly observed in young subjects. The spatular form is often accompanied by metacarpal fractures. We report a clinical case of complete dorsal carpo-metacarpal spatular dislocation. This was a 34-year-old patient, admitted for a closed trauma of the right hand, in whom the clinical examination noted edema of the hand. The radiological workup showed a complete dorsal spatular dislocation associated with a fracture of the base of the 2nd metacarpal. The reduction of these lesions in closed focus followed by stabilization by metacarpal broaching associated with an intermetacarpal transverse broach was done under scopic control in emergency. Functional rehabilitation was started in the 3rd week. The broaches were ablated at the 6th week. The functional result at 3 months was satisfying with good muscle strength. Resumption of work was effective at 8 weeks. Carpo-metacarpal dislocations are rare injuries, often unrecognized, especially in polytrauma patients, and have a good functional prognosis if they are managed correctly in an emergency.
文摘Carpo-metacarpal dislocations are rare hand injuries. They are misdiagnosed due to their non-specific clinical signs. The authors report on their experience in the management of carpometacarpal dislocations in a specialized hand surgery center. Our study included patients received and treated in the department for a carpometacarpal dislocation. Dislocation fractures of Bennett and Rolando were excluded. The postoperative functional evaluation took place after 18 months by the DASH score. Twelve patients participated: one case of neuro-algodystrophy and one pin infection. The mean DASH functional outcome score was 1.10 at 18 months. Since carpometacarpal dislocations are rare and easily misdiagnosed, the surgeon should assume the possibility of them in patients with high-energy trauma, and imaging studies should be carefully evaluated. Pinning is an effective treatment option that provides good long-term functional results.
