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Joint Diseases and
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Case Report · Open access

Chronic dislocations of the fourth and fifth carpometacarpal joints with successful treatment by ligament repair: A case report and literature review

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Hiroyuki Kono

Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan Department of Orthopaedic Surgery, National Hospital Organization Kofu National Hospital, Yamanashi, Japan

ORCID: 0009-0009-1208-740X

Masanori Saito

Department of Orthopaedic Surgery, National Hospital Organization Kofu National Hospital, Yamanashi, Japan

ORCID: 0009-0004-8142-7272

Nobutaka Sato

Department of Orthopaedic Surgery, National Hospital Organization Kofu National Hospital, Yamanashi, Japan

ORCID: 0000-0002-4926-538X

Satoshi Ochiai

Department of Orthopaedic Surgery, National Hospital Organization Kofu National Hospital, Yamanashi, Japan

ORCID: 0000-0001-7202-6101

Jiro Ichikawa

Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan

ORCID: 0000-0002-9850-6047

Masanori Wako

Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan

ORCID: 0000-0001-6311-7909

Hirotaka Haro

Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan

ORCID: 0000-0002-5630-9600

Tetsuo Hagino

Department of Orthopaedic Surgery, National Hospital Organization Kofu National Hospital, Yamanashi, Japan

ORCID: 0000-0001-8669-2615

Abstract

Dislocations of the fourth and fifth carpometacarpal joints (CMCJs) are rare and often misdiagnosed via radiography. Moreover, treatment strategies have not yet been standardized. Herein, we report a case of chronic dislocations of the fourth and fifth CMCJs with delayed diagnosis and successful treatment via ligament repair. A 29-year-old male patient who was initially diagnosed with contusion at another center following a fall on the stairs was referred to our hospital one month later due to persistent pain and swelling. Fourth and fifth CMCJ dislocations were diagnosed using radiography and computed tomography. Closed reduction attempts were unsuccessful, prompting open reduction. The operative findings included rupture of the dorsal carpometacarpal ligament and hamate cartilage injury. Using two mini anchors, the fourth and fifth dorsal carpometacarpal ligaments were repaired, and Kirschner-wire (K-wire) pinning was performed. The K-wire was extracted after four weeks. At the eight-month follow-up, the only remaining symptom was mild discomfort, and the range of motion and grip strength was fully recovered. Our findings highlight the difficulties in diagnosing CMCJ dislocation and suggest ligament repair as a treatment option for chronic cases of CMCJ dislocation.

Declarations

Informed Consent

A written informed consent was obtained from patient.

Author Contributions

Conception and design: H.K., M.S., N.S., J.I., T.H.; Provision of study materials or patients: H.K., M.S., N.S., S.O., T.H.; Data collection and analysis: H.K., M.S., N.S., T.H.; Manuscript writing: H.K., J.I. All the authors read and approved the final manuscript.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Acknowledgments

The authors thank Ms. Kahori Sano, Azusa Sakamoto, and Sachiko Ichimura for their secretarial assistance.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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