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{
    "pk": 1103,
    "title": "Carpometacarpal Dislocation with Third Metacarpal Fracture",
    "subtitle": null,
    "abstract": "Case Presentation\n: A 17-year-old male presented to the emergency department (ED) due to trauma to the right hand and wrist after punching a locker at school. He had significant soft tissue swelling. Radiographs demonstrated intra-articular metacarpal fractures with associated carpometacarpal dislocations. The dislocation was reduced bedside in the ED and ultimately underwent closed reduction surgical management with orthopedic surgery.\nDiscussion: \nMetacarpal fractures result from high-force impact injuries and account for 30-40% of all hand injuries. The most common sites of second through fifth metacarpal fractures are at the neck and the shaft, with the majority involving the fifth metacarpal neck (commonly coined “boxer’s fractures”). Carpometacarpal (CMC) dislocations are a rare injury associated with high-force impact trauma to the wrist. These injuries account for as little as 1% of all acute hand and wrist injuries. Carpometacarpal dislocations are often difficult to diagnose on physical examination due to significant soft tissue swelling, and they can easily be missed on anterior-posterior views of the hand. Lateral and oblique plain radiograph views are essential in the diagnosis as they are more likely to show dislocations. Despite appropriate plain radiographic views, subtle CMC dislocations may be difficult to discern dependent on the level of dislocation or subluxation and overlapping of joints. These injuries are rare due to otherwise highly stable ligamentous and muscular attachments within the wrist. Because of these attachments, dislocations are often associated with concomitant metacarpal fractures.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "carpometacarpal dislocation"
        },
        {
            "word": "metacarpal fracture"
        }
    ],
    "section": "Images in Emergency Medicine",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/3762c2cm",
    "frozenauthors": [
        {
            "first_name": "Colin",
            "middle_name": "",
            "last_name": "Jorgensen",
            "name_suffix": "",
            "institution": "AMITA Health Resurrection Medical Center, Department of Emergency Medicine, Chicago, Illinois",
            "department": "None"
        },
        {
            "first_name": "Steve",
            "middle_name": "",
            "last_name": "Christos",
            "name_suffix": "",
            "institution": "AMITA Health Resurrection Medical Center, Department of Emergency Medicine, Chicago, Illinois",
            "department": "None"
        }
    ],
    "date_submitted": "2021-11-01T19:57:20Z",
    "date_accepted": "2021-11-01T19:57:20Z",
    "date_published": "2021-11-01T19:59:17Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1103/galley/844/download/"
        }
    ]
}