Department of Emergency Medicine, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey.
J Coll Physicians Surg Pak. 2022 Aug;32(8):S171-S173. doi: 10.29271/jcpsp.2022.Supp2.S171.
Carpometacarpal joint dislocations represent not more than 1% of all hand injuries due to stable joint structures and high-energy trauma mechanism. Unfortunately, there are many missed cases suffering from ongoing pain and loss of function because of difficulty in diagnosis. Here we present a case of a healthy 42-year male who presented to the emergency department with hand pain after a punch injury. On physical examination, painful swelling at the dorsal side of his right hand was noted. His radiographic images showed dorsal dislocation of fourth and fifth carpometacarpal joints, and the dislocations were reduced to the anatomical position by the emergency physician without any complication. In the case of carpometacarpal joint fracture or dislocations, early diagnosis and reduction are the most critical steps to avoid severe morbidity, and it is only possible with careful evaluation of physical and radiological findings. In conclusion, as seen in our case, emergency physicians should remain vigilant in the diagnosis and treatment of rare traumatic injuries. Key Words: Carpometacarpal joints, Dislocation, Hand injury, Pain.
腕掌关节脱位在所有手部损伤中占比不超过 1%，这主要是由于腕掌关节结构稳定和高能量创伤机制所致。不幸的是，由于诊断困难，许多患者会出现持续性疼痛和功能丧失而被漏诊。在这里，我们报告了 1 例 42 岁健康男性的病例，他因拳击伤后手痛就诊于急诊科。体格检查发现其右手背侧有压痛性肿胀。其影像学检查显示第四和第五腕掌关节背侧脱位，急诊医生在无任何并发症的情况下将其复位至解剖位置。在腕掌关节骨折或脱位的情况下，早期诊断和复位是避免严重并发症的最关键步骤，这只有通过仔细评估体格检查和影像学检查结果才能实现。总之，正如我们的病例所见，急诊医生在诊断和治疗罕见的创伤性损伤时应保持警惕。关键词：腕掌关节；脱位；手部损伤；疼痛。
