[Multiple carpometacarpal fracture-dislocation]. / Fractura-luxación carpometacarpiana múltiple.
Acta Ortop Mex
; 23(3): 149-52, 2009.
Article
em Es
| MEDLINE
| ID: mdl-19739349
Multiple carpometacarpal fracture dislocations are rare lesions despite the increased number of high-energy traumatic injuries. These lesions result from high-energy traumas or, even more frequently, from fall mechanisms involving palmar flexion of the hand. The diagnosis usually requires specific X-ray views to prevent overlooking those lesions. A 27-year-old male presented at the emergency room in our hospital after sustaining a direct trauma on the right hand, in palmar flexion, resulting from a stair fall. The patient had severe inflammation of the dorsal aspect of the hand, pain, limitation, and complete functional disability. X-rays led to diagnosing fracture dislocation of the hamate, capitate and base of the 3rd, 4th, and 5th metacarpal bones. Treatment consisted of closed reduction under fluoroscopic control, fixation with Orthofix threaded nails and placement of a fiberglass cast in functional position for six weeks. The patient's clinical and radiological course was appropriate; healing of the hamate, capitate, and base of the 3rd, 4th and 5th metacarpal bones was attained without necrosis of the carpal bones. The Orthofix threaded nails were removed. After a period of functional rehabilitation the patient course was appropriate, without any functional limitation of the hand joints. This is an unusual lesion with only a few bibliographic references. We think that a specific X-ray study is fundamental to prevent overlooking these lesions. In this case our priority was reconstructing the base to assure articular continuity and stabilization with threaded Orthofix nails, given the high degree of instability of the lesion.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traumatismo Múltiplo
/
Luxações Articulares
/
Fraturas Ósseas
/
Articulações Carpometacarpais
Tipo de estudo:
Diagnostic_studies
Limite:
Adult
/
Humans
/
Male
Idioma:
Es
Revista:
Acta Ortop Mex
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2009
Tipo de documento:
Article
País de publicação:
México