Abstract
Background Ulnar carpometacarpal (CMC) joint dislocations and fracture–dislocations are uncommon
injuries that are often overlooked. Most authors advocate surgical stabilization in
order to prevent a secondary dislocation assuming that these injuries are inherently
unstable.
Case Description This is a series of eight ulnar CMC joint dislocations and fracture–dislocations
treated by closed reduction and splint immobilization after assessing the joint stability.
Mean follow-up was 30.2 months, and minimum follow-up was 12 months. Satisfactory
results were obtained in range of motion, grip strength, pain, DASH (Disabilities
of the Arm, Shoulder and Hand) questionnaire, and time to return to working activities.
In the same period, the closed reduction and cast failed two (20%) cases that were
referred for surgery.
Literature Review There is little published literature on the nonoperative treatment of these injuries.
Most of them are isolated case reports, whereas the largest series reports four cases.
All of them have reported satisfactory results.
Clinical Relevance Based on our results, we believe that if the diagnosis of an ulnar CMC joint dislocation
or fracture–dislocation is early accomplished and a concentric and stable reduction
is initially achieved, the nonoperative treatment may be a successful option to take
into account but requiring a close follow-up for the first week.
Keywords
carpal - dislocation - fracture - metacarpal - ulnar
