Complex Volar Carpometacarpal Dislocation with Concomitant Thumb Interphalangeal Injury: A Case Report.

INTRODUCTION

Carpometacarpal (CMC) dislocations are rare and usually result from high-energy trauma. The most frequent direction of dislocation is dorsal, even if the dorsal ligaments are stronger than the volar ones. We report a case of volar CMC dislocation with concomitant thumb interphalangeal injury.

CASE REPORT: We report the case of a 30-year-old right-handed male who sustained a left volar CMC dislocation with an associated posterolateral interphalangeal dislocation of the thumb following a motorcycle accident. Clinical examination revealed dorsal concavity of the hand and a thumb deformity with a 2-cm open wound, while finger mobility and sensation were preserved. Standard radiographs confirmed the dislocations. The patient underwent wound debridement and closed reduction under general anesthesia, followed by immobilization with an anterior splint including the thumb. Complete wound healing was achieved by day 12, and the splint was removed at 45 days. Progressive active mobilization started in the 3rd post-operative week. At 3 months follow-up, the patient had full recovery of wrist and finger motion and returned to work at 8 weeks.

CONCLUSION

Early diagnosis, careful reduction, and structured rehabilitation are key in managing complex volar CMC dislocations with concomitant thumb injuries. Multidisciplinary management ensures optimal functional outcomes and prevents long-term disability.