{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:58:13Z","timestamp":1781585893277,"version":"3.54.5"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Carpometacarpal dislocations are rare injuries whose diagnosis is often missed initially. These injuries can be treated conservatively, as long as an anatomical closed reduction is achieved. However, in most cases, open reduction followed by internal or external fixation is necessary to reach a stable anatomical reduction.<\/jats:p><jats:p>\n          Case Description\u2003A 32-year-old male was referred to our institution due to excess swelling of his right hand, 2 months after a motorcycle crash he sustained. During our imaging workup, a dorsal carpometacarpal dislocation of all four ulnar metacarpals was found accompanied by a fracture of the base of the fifth metacarpal. An open reduction was achieved using Kirschner wires and a small plate for arthrodesis of the fifth carpometacarpal joint. The postoperative follow-up on the 3rd, 6th, and 12th month was uncomplicated. The range of motion and grip strength was satisfactory on the 3rd month and almost full on the 6th month compared to the unaffected side.<\/jats:p><jats:p>\n          Literature Review\u2003Carpometacarpal dislocations are rare hand injuries. They are often the result of a high-energy injury and their diagnosis is usually delayed or missed. The main reasons are the excessive pain and swelling of the hand which make the initial clinical examination difficult and the overlapping of the metacarpals on the X-ray, which make the radiological diagnosis challenging.<\/jats:p><jats:p>\n          Case Relevance\u2003A delayed diagnosis needs urgent open surgical treatment to achieve an anatomical reduction due to the interposition of soft tissue, bony fragments, and newly formed callus. Diagnosis and treatment of these injuries demands a high clinical suspicion from the traumatologist. The role of computed tomography scan is invaluable and open reduction is the mainstay of treatment for the cases that are diagnosed late.<\/jats:p>","DOI":"10.1055\/s-0043-1761285","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T23:59:52Z","timestamp":1677801592000},"page":"164-170","source":"Crossref","is-referenced-by-count":3,"title":["Delayed Diagnosis of Dislocation of All Four Ulnar Carpometacarpal Joints. Surgical Treatment Strategy and Challenges."],"prefix":"10.1055","volume":"13","author":[{"given":"Eftychios","family":"Papagrigorakis","sequence":"additional","affiliation":[{"name":"Hand Surgery-Upper Extremity & Microsurgery Unit, KAT General Hospital of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Vlachos","sequence":"additional","affiliation":[{"name":"Hand Surgery-Upper Extremity & Microsurgery Unit, KAT General Hospital of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Galanis","sequence":"additional","affiliation":[{"name":"Hand Surgery-Upper Extremity & Microsurgery Unit, KAT General Hospital of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Kanellos","sequence":"additional","affiliation":[{"name":"Hand Surgery-Upper Extremity & Microsurgery Unit, KAT General Hospital of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1080\/23320885.2021.1910039","article-title":"Dislocation of ulnar side all four carpometacarpal joints - a case report","volume":"8","author":"R K Shah","year":"2021","journal-title":"Case Reports Plast Surg Hand Surg"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1177\/1558944719852743","article-title":"Carpometacarpal fracture-dislocations: a retrospective review of injury characteristics and radiographic outcomes","volume":"16","author":"G Steinmetz","year":"2021","journal-title":"Hand (N Y)"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"319","DOI":"10.2214\/ajr.140.2.319","article-title":"Systematic approach to identifying fourth and fifth carpometacarpal joint dislocations","volume":"140","author":"M R Fisher","year":"1983","journal-title":"AJR Am J Roentgenol"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S0363-5023(09)90011-9","article-title":"Transcarpal carpometacarpal dislocations, excluding the thumb","volume":"15","author":"M Garcia-Elias","year":"1990","journal-title":"J Hand Surg Am"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s00068-015-0611-z","article-title":"Management algorithm for index through small finger carpometacarpal fracture dislocations","volume":"42","author":"C B\u00fcren","year":"2016","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"215","DOI":"10.31486\/toj.18.0151","article-title":"Isolated volar dislocation of the fifth carpometacarpal joint","volume":"20","author":"B Desai","year":"2020","journal-title":"Ochsner J"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/S0363-5023(03)00373-3","article-title":"Anatomy and pathomechanics of ring and small finger carpometacarpal joint injuries","volume":"28","author":"R Yoshida","year":"2003","journal-title":"J Hand Surg Am"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"e1900558","DOI":"10.2106\/JBJS.CC.19.00558","article-title":"Complex, multidirectional carpometacarpal dislocations: a case report","volume":"10","author":"A Dhal","year":"2020","journal-title":"JBJS Case Connect"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.jcot.2020.05.039","article-title":"Fracture dislocations of the carpometacarpal joints of the fingers","volume":"11","author":"P Bhardwaj","year":"2020","journal-title":"J Clin Orthop Trauma"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1053\/jhsu.2001.28761","article-title":"Three-dimensional kinematic analysis of the second through fifth carpometacarpal joints","volume":"26","author":"M El-Shennawy","year":"2001","journal-title":"J Hand Surg Am"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.hcl.2006.02.004","article-title":"Degenerative and post-traumatic arthritis affecting the carpometacarpal joints of the fingers","volume":"22","author":"T R Hunt III","year":"2006","journal-title":"Hand Clin"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1142\/S0218810405002498","article-title":"Ulnar dislocation of fifth carpometacarpal joint","volume":"10","author":"A J Saleemi","year":"2005","journal-title":"Hand Surg"},{"key":"ref13","first-page":"4962021","article-title":"Conservative treatment of carpometacarpal dislocation of the three last fingers","volume":"2016","author":"H Jumeau","year":"2016","journal-title":"Case Rep Emerg Med"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s13256-018-1695-y","article-title":"Divergent dislocation of the carpometacarpal joints: a case report","volume":"12","author":"R Hani","year":"2018","journal-title":"J Med Case Reports"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1053\/jhsu.2001.20153","article-title":"Divergent fracture-dislocation of the second carpometacarpal joint and the three ulnar carpometacarpal joints","volume":"26","author":"R Kumar","year":"2001","journal-title":"J Hand Surg Am"},{"issue":"08","key":"ref16","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1016\/j.otsr.2020.03.039","article-title":"Ulnar-sided carpometacarpal fractures and fractures-dislocations. A systematic review and publication guidelines","volume":"106","author":"C Chaves","year":"2020","journal-title":"Orthop Traumatol Surg Res"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1302\/0301-620X.69B2.3818751","article-title":"Carpometacarpal dislocation. An easily missed diagnosis","volume":"69","author":"J J Henderson","year":"1987","journal-title":"J Bone Joint Surg Br"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1177\/1753193414562706","article-title":"Fracture-dislocations of the carpometacarpal joints of the ring and little finger","volume":"40","author":"S V Gehrmann","year":"2015","journal-title":"J Hand Surg Eur Vol"},{"issue":"11","key":"ref19","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1016\/j.jhsa.2015.07.017","article-title":"The effect of timing on the treatment and outcome of combined fourth and fifth carpometacarpal fracture dislocations","volume":"40","author":"C Zhang","year":"2015","journal-title":"J Hand Surg Am"},{"key":"ref20","first-page":"73","article-title":"Fracture and fracture dislocation of ulnar carpometacarpal joint","volume":"11","author":"S Chmell","year":"1982","journal-title":"Orthop Rev"},{"issue":"04","key":"ref21","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1177\/2292550320933690","article-title":"Carpometacarpal joint dislocations: management and long-term outcomes at a specialized hand surgery center in Latin America","volume":"28","author":"J E Telich-Tarriba","year":"2020","journal-title":"Plast Surg (Oakv)"},{"issue":"12","key":"ref22","first-page":"e12310","article-title":"Isolated dorsal dislocations of the fourth and fifth carpometacarpal joints: a case report and review of literature","volume":"12","author":"S Metikala","year":"2020","journal-title":"Cureus"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1007\/s11552-011-9347-3","article-title":"Acute ulnar carpometacarpal dislocations. Can it be treated conservatively? A review of four cases","volume":"6","author":"G Storken","year":"2011","journal-title":"Hand (N Y)"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1016\/S0363-5023(87)80064-3","article-title":"Hamatometacarpal fracture-dislocation: classification and treatment","volume":"12","author":"J E Cain Jr","year":"1987","journal-title":"J Hand Surg Am"},{"issue":"06","key":"ref25","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.otsr.2016.04.003","article-title":"Rare carpometacarpal dislocations","volume":"102","author":"M Lefere","year":"2016","journal-title":"Orthop Traumatol Surg Res"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/0020-1383(92)90197-Z","article-title":"Closed volar dislocation of the four ulnar carpometacarpal joints","volume":"23","author":"R A Bajekal","year":"1992","journal-title":"Injury"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/S0020-1383(05)80042-7","article-title":"Carpometacarpal dislocation: an aid to diagnosis","volume":"23","author":"R W Parkinson","year":"1992","journal-title":"Injury"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/J.JHSB.2006.09.020","article-title":"The \u2018metacarpal cascade lines\u2019; use in the diagnosis of dislocations of the carpometacarpal joints","volume":"32","author":"P D Hodgson","year":"2007","journal-title":"J Hand Surg Eur Vol"},{"issue":"04","key":"ref29","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.jhsa.2007.11.019","article-title":"Management of intra-articular metacarpal base fractures of the second through fifth metacarpals","volume":"33","author":"B D Bushnell","year":"2008","journal-title":"J Hand Surg Am"},{"issue":"10","key":"ref30","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1007\/s004020000140","article-title":"The \u2018mirrored\u2019 Bennett fracture of the base of the fifth metacarpal","volume":"120","author":"A Y Goedkoop","year":"2000","journal-title":"Arch Orthop Trauma Surg"},{"issue":"02","key":"ref31","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1055\/s-0039-1688468","article-title":"Nonoperative treatment of ulnar carpometacarpal fracture-dislocations","volume":"9","author":"I Jim\u00e9nez","year":"2020","journal-title":"J Wrist Surg"},{"issue":"01","key":"ref32","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/0072-968X(74)90016-3","article-title":"Fracture-subluxation of base of fifth metacarpal","volume":"6","author":"P W Petrie","year":"1974","journal-title":"Hand"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/0266-7681(92)90075-D","article-title":"Intra-articular fractures at the base of the fifth metacarpal. A clinical and radiographical study of 64 cases","volume":"17","author":"K Kjaer-Petersen","year":"1992","journal-title":"J Hand Surg [Br]"},{"issue":"03","key":"ref34","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1055\/s-0039-1693051","article-title":"Surgical treatment for delayed ulnar carpometacarpal fracture-dislocations","volume":"9","author":"J Kato","year":"2020","journal-title":"J Wrist Surg"},{"issue":"01","key":"ref35","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s12306-018-0571-7","article-title":"Use of dorsal buttress plate fixation for ulnar carpometacarpal joint fracture dislocations for early mobilization: outcomes of 11 cases","volume":"103","author":"S C Tay","year":"2019","journal-title":"Musculoskelet Surg"}],"container-title":["Journal of Wrist Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1761285.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T12:14:51Z","timestamp":1730808891000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1761285"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,2]]},"references-count":35,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2024,3,18]]},"published-print":{"date-parts":[[2024,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1761285","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2163-3916","2163-3924"],"issn-type":[{"value":"2163-3916","type":"print"},{"value":"2163-3924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,2]]}}}