Isolated Dislocation of Fifth Carpometacarpal Joint: Case Report and Literature Review

單獨第五掌腕關節單純脫臼：病例報告與文獻探討

李宜軒(Yi-Hsuan Lee) ； 陳鍾沛(Chung-Pei Chen) ； 李宜展(Yi-Chan Lee) ； 李岳章(Yueh-Chang Lee) ； 彭孟炤(Meng-Chao Peng)

《輔仁醫學期刊》 17卷4期 (2019/12) Pp. 199-205

https://doi.org/10.3966/181020932019121704005

摘要

Isolated pure dorsal dislocation of the carpometacarpal (CMC) joint of the fifth finger is a rare hand injury. It is often difficult to diagnose and can easily be overlooked if clinicians are unaware of the clinical signs and subtle radiographic findings. Once neglected and left untreated, such injuries may result in long-term disabilities. Diagnosis is made both clinically and radiologically. A systemic approach should be adopted for the wrist radiograph involving standard anteroposterior, true lateral, and 30° pronated views. Treatments including closed reduction followed by casting, percutaneous pinning, and open reduction with internal fixation have been reported. This report presents an isolated pure dislocation of the fifth carpometacarpal joint that was successfully treated surgically. The anatomy, mechanism of injury, clinical features, diagnosis, and treatment options are discussed along with a review of the available literature.

關鍵字

carpometacarpal ； dislocation

並列摘要

目的：單獨第五腕掌關節單純脫臼在臨床上十分少見，在此篇文章中我們將探討此種損傷的解剖構造、受傷機轉、診斷與治療方式。方法與結果：這篇文章中我們報告一位21歲男性因車禍導致手部疼痛腫脹而至急診求診，經理學檢查與影像學檢查後診斷為單獨第五腕掌關節單純脫臼，病人接受閉鎖復位經皮骨釘手術，術後恢復良好。結論：單獨第五腕掌關節單純脫臼在臨床上十分少見，約佔所有手部傷害不到1%，歷史文獻中只有少數零星案例報告。也由於罕見，容易被忽略或延遲診斷，導致慢性疼痛或甚至創傷性關節炎。手術方式包括徒手復位或經皮骨釘合併石膏固定治療皆有文獻報導，建議應依照治療時間點與術中關節穩定度來決定。

並列關鍵字

腕掌關節 ； 脫臼