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Dorsal buttress plate fixation for the treatment of fracture–dislocation of the fifth carpometacarpal joint with avulsion fracture of the hamate: a case report

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Abstract

Fracture–dislocations of the fourth and fifth carpometacarpal (CMC) joints present a complex situation. Misdiagnosis and inadequate treatment may cause malunion and residual subluxation, which lead to painful arthritis and grip weakness. Open reduction along with internal fixation is the treatment of choice, but there is no consensus on an optimal treatment approach. We applied a novel surgical technique to treat a case of a fracture–dislocation of the fifth CMC joint with avulsion fracture of the hamate using a dorsal buttress plate between the hamate and the capitate. This method allowed for achieving rigid fixation without screw insertion across the bone fragments of the hamate. We could avoid the risk of unexpected fragmentation and unexpected damage to the volar neurovascular bundles around the hook of the hamate. Six months postoperatively, bone union was achieved and the reduction of the fourth and fifth CMC joints was maintained. Range of motion of the fourth and fifth CMC joints was almost equal to that on the contralateral side. Dorsal buttress plating between the hamate and the capitate could be an alternative technique for the treatment of fracture–dislocation of the fifth CMC joint with avulsion fracture of the hamate.

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Acknowledgements

The authors report no benefits, grants, or assistance from any party.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kizawa Memorial Hospital, Gifu, Japan

    Naoya Iwata, Shigeo Kanamori, Takahiro Masuda & Yoshiki Ito

  2. Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu, 501-1194, Japan

    Shingo Komura, Akihiro Hirakawa & Haruhiko Akiyama

Authors
  1. Naoya Iwata
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  2. Shingo Komura
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  3. Akihiro Hirakawa
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  4. Shigeo Kanamori
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  5. Takahiro Masuda
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  6. Yoshiki Ito
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  7. Haruhiko Akiyama
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Corresponding author

Correspondence to Shingo Komura.

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Iwata, N., Komura, S., Hirakawa, A. et al. Dorsal buttress plate fixation for the treatment of fracture–dislocation of the fifth carpometacarpal joint with avulsion fracture of the hamate: a case report. Arch Orthop Trauma Surg 139, 135–139 (2019). https://doi.org/10.1007/s00402-018-3072-0

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  • DOI: https://doi.org/10.1007/s00402-018-3072-0

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