Volume 7, Issue 1, February 2019, Page: 24-27
Floating Thumb with Simultaneous Carpometacarpal and Metacarpo-phalangeal Dislocation: A Case Report
Xiang Li, Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
Frankie Leung, Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
Christian Fang, Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
Tak Man Wong, Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
Received: Feb. 17, 2019;       Accepted: Apr. 2, 2019;       Published: Apr. 22, 2019
DOI: 10.11648/j.js.20190701.15      View  33      Downloads  13
Abstract
Double dislocation of carpometacarpal and metacarpo-phalangeal joints of thumb is also called ‘floating thumb metacarpal’. This rare injury usually presents with combined joints dislocation and collateral ligaments rupture, which may be predisposing to joint instability after closed reduction. We report a case of traumatic and chronic dislocation of carpometacarpal and metacarpo-phalangeal joints of left thumb in a 63-year-old housewife. Failure of non-operative treatment was found up to 1 month after injury due to missed follow-up. Closed reduction was tried but failed because of joints stiffness. Open reduction and K-wire fixation were performed and radial collateral ligaments were repaired. Patient restored good functional outcome with no evidence of arthritis or subluxation at 1 year. Open reduction and fixation show good result in our case with delayed surgical intervention. The management of a floating thumb could be non-operative by close reduction and cast immobilization. However, closed monitoring and regular follow-up are critical after non-operative treatment to avoid potential risk of post-operative complications.
Keywords
Double Dislocation of Carpometacarpal and Metacarpo-Phalangeal, Floating Thumb, Carpometacarpal, Metacarpo-Phalangeal
To cite this article
Xiang Li, Frankie Leung, Christian Fang, Tak Man Wong, Floating Thumb with Simultaneous Carpometacarpal and Metacarpo-phalangeal Dislocation: A Case Report, Journal of Surgery. Vol. 7, No. 1, 2019, pp. 24-27. doi: 10.11648/j.js.20190701.15
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Drosos, G., E. Kayias, and K. Tsioros, "Floating thumb metacarpal" or complete dislocation of the thumb metacarpal: a case report and review of the literature. Injury, 2004. 35(5): p. 545-8.
[2]
KS, S., et al., Simultaneous dislocation of the carpometacarpal and metacarpophalangeal joints of the thumb in a motorcyclist. Journal of the Formosan Medical Association = Taiwan yi zhi, 2006. 105(8): p. 670-3.
[3]
Couceiro, J., et al., Thumb carpometacarpal dislocation and open dorsal metacarpophalangeal instability: a variation of the floating thumb. Arch Plast Surg, 2014. 41(2): p. 190-2.
[4]
HR, T., et al., Traumatic Floating 1st Metacarpal in a 14-Year-Old Boy Managed by Close Reduction and Thumb Spica Immobilization: A Rare Case Report. 2014. 4(4): p. 44-7.
[5]
Messaoudi, T., et al., Floating thumb metacarpal in a motorcyclist: A case report. Chirurgie de la main, 2015. 34(2): p. 91-93.
[6]
Ibrahim, S. and M. Noor, Simultaneous dislocations of the carpometacarpal and metacarpophalangeal joints of the thumb. Injury, 1993. 24(5): p. 343-4.
[7]
Rajeev, A., S. Noureldin, and D. Graham, Floating thumb with double dislocation of carpometacarpal and metacarpo-phalangeal joints. Int J Surg Case Rep, 2014. 5(12): p. 1102-5.
[8]
Gerard, F., Y. Tropet, and L. Obert, Trapezo-metacarpal and metacarpo-phalangeal dislocation of the thumb associated with a carpo-metacarpal dislocation of the four fingers. Chir Main, 1999. 18(3): p. 205-8.
[9]
Khan, H., P. Darcy, and P. Magnussen, Simultaneous Volar Dislocations of Carpometacarpal and Metacarpophalangeal Joints of the Thumb. J Orthop Case Rep, 2012. 2(3): p. 8-11.
[10]
Moore, J., C. Webb, and R. Thompson, A complete dislocation of the thumb metacarpal. J Hand Surg Am, 1978. 3(6): p. 547-9.
[11]
Marcotte, A. and M. Trzeciak, Nonoperative treatment for a double dislocation of the thumb metacarpal: a case report. Arch Orthop Trauma Surg, 2008. 128(3): p. 281-4.
[12]
Sakuma, M. and G. Inoue, Simultaneous dorsal dislocation of the metacarpophalangeal and carpometacarpal joints of a finger. Arch Orthop Trauma Surg, 1998. 117(4-5): p. 286-7.
Browse journals by subject