Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Apr 1988
Case ReportsTraumatic volar dislocation of the second, third and fourth carpometacarpal joints: mechanism and manipulation.
Traumatic volar dislocation of the second, third and fourth carpometacarpal joints without associated fracture is extremely rare. A single case, treated successfully by manipulative reduction supplemented with splint immobilization and isometric and isotonic muscle exercise is reported, with restoration of complete anatomical alignment revealed by postmanipulative radiographs. ⋯ The conservative traction-dorsiflexion manipulative reduction for multiple volar carpometacarpal joint dislocations is described and recommended before using open reduction. Based on the case, it is postulated that the mechanism of a carpometacarpal joint dislocation is due to a sudden violent force acting almost perpendicularly to the metacarpal head or heads; the reactive forces create the opposite directed forces as a lever type of strain on the involved carpometacarpal joint and produce the dislocation.