Isolated first carpometacarpal joint dislocation managed with closed reduction and splinting

Abstract

A 56-year-old man, right-hand-dominant office worker, complained of pain and swelling at the base of his right thumb after using his hand to press onto the front passenger seat during an emergency brake. X-ray showed a dorsal dislocation of the first carpometacarpal joint of his right hand. Closed reduction of the joint was performed. As there were no clinical signs of instability post-reduction and X-ray confirmed that the joint was congruent, the joint was immobilised in a thumb spica splint for 6 weeks. His pain subsided and the range of motion of his first carpometacarpal joint was full at 9 weeks post-injury. Two years after the injury, he was asymptomatic and X-ray revealed normal joint anatomy with no obvious subluxation or osteoarthritic change. For patients with first carpometacarpal joint dislocations, non-operative management with splinting is a good option if the joint is stable post-reduction.