A rare combined injury of dorsal fracture-dislocation of four carpometacarpal joints and trapezium, trapezoid and distal radius bone fractures

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Georgios Touloupakis
Wilfried Stuflesser
Guido Antonini
Fabrizio Ferrara
Cornelio Crippa
Maria Gabriella Lettera


Multiple carpometacarpal dislocation, radius fracture concomitant carpal lesions, open reduction internal fixation, metacarpal bones


Incorrect or delayed diagnosis and treatment of the carpometacarpal fracture-dislocations is often associated with poor prognosis. We present a rare case of unusual pattern of injury, involving dorsal dislocation of four ulnar carpometacarpal joints, associated with fracture of the trapezium, a burst fracture of the trapezoid  bone and an extra-articular fracture of the third distal  of the radius.
The first surgical intervention was followed by unsatisfactory results, confirmed by the CT scans. A second surgery followed and an open reduction and pinning with K wires performed. Post-operative follow up lasting for nine months revealed a very good surgical outcome.


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