scholarly journals Volar Dislocation of the Fourth and Fifth Carpometacarpal Joint Associated with Hamate Hook Fracture: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Natsumi Saka ◽  
Hirotada Matsui ◽  
Hideki Tsuji
Keyword(s):  
Carpometacarpal Joint ◽  
Kirschner Wires ◽  
Rare Injury ◽  
Intraoperative Computed Tomography ◽  
Flexor Carpi Ulnaris ◽  
Metacarpal Bones ◽  
Hamate Hook Fracture ◽  
Ligamentous Structure ◽  
Displaced Fracture ◽  
Cmc Joint

We report a case of volar fourth and fifth carpometacarpal (CMC) joint dislocation complicated by a hamate hook fracture. The CMC joint was reduced in a closed fashion and temporally fixed with Kirschner wires. Using intraoperative computed tomography, the displaced fracture of the hamate hook was reduced by open reduction and internal fixation and fixed with a screw. We suggest that this rare injury was caused by the over contraction of the flexor carpi ulnaris and avulsion force from the ligamentous structure around the pisiform, hamate, and metacarpal bones.

scholarly journals An Ulnar-Type Dislocation of Fifth Carpometacarpal Joint: Case Report and Review of the Literature

2019 ◽  
Vol 12 (S 01) ◽  
pp. S61-S63
Author(s):  
Vijay A. Malshikare
Keyword(s):  
Case Report ◽  
Review Of The Literature ◽  
Carpometacarpal Joint ◽  
Rare Injury ◽  
Soft Tissue Swelling ◽  
Polytrauma Patients ◽  
Type Dislocation ◽  
K Wires ◽  
Type Of Injury ◽  
Cmc Joint

AbstractUnilateral pure dislocation of the fifth carpometacarpal joint (CMCJ) is a very rare injury. We are reporting the second case of an ulnar type of unilateral dislocation of a fifth CMCJ. Indian salutation (Namaskar) test and radiographs aid in diagnosis. Closed reduction and internal fixation by K-wires restored the normal anatomic relationships of the fifth CMC joint. This type of injury is prone to be missed in an emergency room due to soft tissue swelling, and particular attention should be paid to diagnose it in polytrauma patients. A review of the literature is presented.

scholarly journals Medial Humeral Epicondylar Fracture in Children and Adolescents

2007 ◽  
Vol 15 (2) ◽  
pp. 170-173 ◽  
Author(s):  
D Ip ◽  
WL Tsang
Keyword(s):  
Treatment Outcomes ◽  
Mayo Clinic ◽  
Kirschner Wire ◽  
Young Patients ◽  
Tension Band ◽  
Kirschner Wires ◽  
Range Of Movement ◽  
Cubitus Valgus ◽  
Tension Band Wire ◽  
Displaced Fracture

Purpose. To assess treatment outcomes of young patients with medial epicondylar fracture of the elbow using standard operative protocols. Methods. 24 consecutive patients with medial humeral epicondylar fracture underwent surgery by one of the 3 methods: (1) 2 parallel Kirschner wires, (2) 2 parallel Kirschner wires plus a tension-band wire, and (3) a screw plus an anti-rotation Kirschner wire. Fractures displaced less than 5 mm were treated conservatively (casting for 3 weeks). Outcome was assessed clinically and radiologically. The Mayo Clinic Elbow Performance Index was measured. Results. The 3 patients with undisplaced fractures had good radiological results and scores. One patient with a displaced fracture refused surgery and subsequently developed pseudarthrosis and cubitus valgus. All operatively treated patients had good scores, but 2 treated with 2 parallel Kirschner wires alone developed pseudarthrosis. Patients in this group needed longer rehabilitation to attain a functional range of movement than those in other groups (treated together with a tension-band wire or screw). Conclusion. Surgery is recommended for children with displaced medial epicondylar fractures of more than 5 mm. The use of a tension-band wire, instead of a screw, together with Kirschner wires is the preferred treatment for younger children.

scholarly journals UK DRAFFT: a randomised controlled trial of percutaneous fixation with Kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius

2015 ◽  
Vol 19 (17) ◽  
pp. 1-124 ◽  
Author(s):  
Matthew L Costa ◽  
Juul Achten ◽  
Caroline Plant ◽  
Nick R Parsons ◽  
Amar Rangan ◽  
...  
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Plate Fixation ◽  
Kirschner Wire ◽  
Health Technology ◽  
Kirschner Wires ◽  
Locking Plate Fixation ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Displaced Fracture

BackgroundIn high-income countries, 6% of all women will have sustained a fracture of the wrist (distal radius) by the age of 80 years and 9% by the age of 90 years. Advances in orthopaedic surgery have improved the outcome for patients: many such fractures can be treated in a plaster cast alone, but others require surgical fixation to hold the bone in place while they heal. The existing evidence suggests that modern locking-plate fixation provides improved functional outcomes, but costs more than traditional wire fixation.MethodsIn this multicentre trial, we randomly assigned 461 adult patients having surgery for an acute dorsally displaced fracture of the distal radius to either percutaneous Kirschner-wire fixation or locking-plate fixation. The primary outcome measure was the Patient-Rated Wrist Evaluation©(PRWE) questionnaire at 12 months after the fracture. In this surgical trial, neither the patients nor the surgeons could be blind to the intervention. We also collected information on complications and combined costs and quality-adjusted life-years (QALYs) to assess cost-effectiveness.ResultsThe baseline characteristics of the two groups were well balanced and over 90% of patients completed follow-up. Both groups of patients recovered wrist function by 12 months. There was no clinically relevant difference in the PRWE questionnaire score at 3 months, 6 months or 12 months [difference at 12 months: –1.3; 95% confidence interval (CI) –4.5 to 1.8;p = 0.398]. There was no difference in the number of complications in each group and small differences in QALY gains (0.008; 95% CI –0.001 to 0.018); Kirschner-wire fixation represents a cost-saving intervention (–£727; 95% CI –£588 to –£865), particularly in younger patients.ConclusionsContrary to the existing literature, and against the increasing use of locking-plate fixation, this trial shows that there is no difference between Kirschner wires and volar locking plates for patients with dorsally displaced fractures of the distal radius. A Kirschner-wire fixation is less expensive and quicker to perform.Trial registrationCurrent Controlled Trials ISRCTN31379280.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 17. See the NIHR Journals Library website for further project information.

Simulated Osteotomy of the Trapezium Reduces Radial Subluxation and Improves Contact Pressure Distribution Across the Thumb Carpometacarpal Joint in Lateral Pinch

2010 ◽  
Author(s):  
Deana Mercer ◽  
Christina Salas ◽  
James Love ◽  
Letitia Lansing ◽  
Amanda Medoro ◽  
...  
Keyword(s):  
Joint Laxity ◽  
Carpometacarpal Joint ◽  
Contact Pressure Distribution ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
Long Term Impact ◽  
Flexion And Extension ◽  
Cmc Joint ◽  
Over Time

Joint laxity and radial subluxation of the metacarpal on the trapezium have been associated with arthritis of the carpometacarpal (CMC) joint of the thumb. In normal flexion and extension of the thumb, the ligaments and the joint are minimally stressed. However, in opposition and lateral pinch (key pinch), the two surfaces rotate on each other, generating an unequal surface stress. Over time, the unequal stresses lead to an asymmetrical wear pattern. This leads to increased strain on the ligaments and may lead to subluxation over time.1 Surgical treatment of early arthritis of the CMC joint includes ligament reconstruction or first metacarpal extension osteotomy to decrease joint laxity. Once laxity exists, joint degeneration is accelerated.2 The long-term impact of painful CMC arthritis on activities of daily living can be debilitating.

Open Reduction and Internal Fixation Using Plate and Screws Versus Percutaneous Kirschner Wires Fixation for Second and Third Metacarpal Bones Fractures: A Meta-analysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Karim Samir Masoud ◽  
Ahmad Fathi El Sherif ◽  
Raghda Elsayed Tallal ◽  
Mahmoud Mahrous Mohamed Waly
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Functional Results ◽  
Kirschner Wires ◽  
Metacarpal Fractures ◽  
Metacarpal Bones ◽  
Surgical Fixation ◽  
Type Of Fracture

Abstract Background Metacarpal fractures are among the most common fractures of the skeletal system and account for 36 % of hand and wrist fractures. Aim of the Work To determine the functional outcome and postoperative complications for both these surgical techniques in the treatment of second and third metacarpal bones fractures. Patients and Methods The systematic review was restricted to clinical studies of both these surgical techniques in the treatment of closed second and third metacarpal fractures. We reviewed studies that include management of metacarpal fractures with open reduction and internal fixation using plate and screws versus percutaneous crossed Kirschner wires fixation. Results No specification was made about the type of fracture, other than shaft fractures located in the second and the third metacarpal. All fractures were operated because of instability, angulations’ or rotational deformity. No comparison can therefore be made between fracture type (i.e. spiral, oblique) and functional results. As all studies reported identical indication for surgical fixation a comparison between type of fixation and functional result can be made. Conclusion Based on the reported results there is no evidence to suggest one fixation technique over another. The reported complications however for ORIF and K-wire fixation in the treatment of metacarpal fractures are unmistakably different for the two types of fixation.

Hawkins type III talar neck fracture dislocation with neurovascular and tendon entrapment in a toddler

2021 ◽  
Vol 14 (5) ◽  
pp. e241830
Author(s):  
Naresh Kumar Saini ◽  
Vijay Kumar Jain ◽  
Karthikeyan P Iyengar
Keyword(s):  
Current Literature ◽  
Functional Outcomes ◽  
Fracture Dislocation ◽  
Radiological Findings ◽  
Rare Injury ◽  
Type Iii ◽  
Emergency Presentation ◽  
Neck Fracture ◽  
Tendon Entrapment ◽  
Displaced Fracture

Paediatric displaced fracture of the neck of talus is extremely rare injury with variable outcomes. We report our experience in managing a Hawkins type III talar neck fracture dislocation with neurovascular and tendon entrapment in a 3-year-old boy. We describe the emergency presentation, radiological findings, orthopaedic management and clinical and functional outcomes in this toddler following the injury with review of the current literature.

scholarly journals Isolated radial volar dislocation of the fifth carpometacarpal joint: a rare injury

2013 ◽  
Vol 16 ◽  
Author(s):  
Khalid Ibn El ◽  
Mohcine Sbiyaa ◽  
Badr Alami ◽  
Ilyass Rabhi ◽  
Amine Marzouki ◽  
...  
Keyword(s):  
Carpometacarpal Joint ◽  
Rare Injury

ISOLATED VOLAR DISLOCATION OF THE FIFTH CARPOMETACARPAL JOINT: A CASE REPORT

Hand Surgery ◽  
2007 ◽  
Vol 12 (03) ◽  
pp. 165-168 ◽  
Author(s):  
Masanori Nakayama ◽  
Yukio Horiuchi ◽  
Hidekazu Kawashima
Keyword(s):  
Case Report ◽  
Carpometacarpal Joint ◽  
Rare Injury

Isolated volar dislocation of the fifth carpometacarpal joint is a very rare injury. We present two cases of isolated volar dislocation of the fifth carpometacarpal joint treated successfully with percutaneous skeletal fixation.

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