Primary fusion of fracture dislocations of central carpometacarpal joints.

Six patients with dislocations or fracture dislocations of at least the second and third carpometacarpal joints are presented. Closed reduction was attempted in all cases. Two dislocations with minimal periarticular fractures were stable and were treated with cast immobilization. Four fracture dislocations were unstable and were treated with primary arthrodesis of the injured joints. One patient was lost to followup and the other 5 were observed for an average of 24 months. Establishment of a stable or rigid central carpometacarpal joint produced an excellent result in 4 patients and a satisfactory result in 1 patient.