Trapezio-Metacarpal Dislocation: A Rare Lesion: About Two Cases



Ben Amor Yosri*

Sfax Medical School, Tunisia

*Corresponding Author: Ben Amor Yosri, Sfax Medical School, Tunisia

Received: March 03, 2022     Published: March 28, 2022

 

Abstract

Purpose: By reporting two cases of trapezio metacarpal dislocation. We studied the physiopathology and surgical treatment.

Observations: The first patient was a 55-year-old man admitted for closed thumb trauma. The clinical exam found Tillaux sign. The radiograph of the hand showed dorsal dislocation of the trapezio metacarpal joint and bone tearing of the base of the first metacarpal. We used Wagner technique for TMJ stabilization. The second patient was a 12-year-old child who presented to describe a closed trauma right thumb. The radiograph of the hand showed a Trans trapezium dislocation of the trapezio-metacarpal joint and a trapezium fracture. Closed reduction, trapezium pinning and Iselin's tri-cortical pinning helped us to stabilize the joint.

Discussion: Trapezio-metacarpal dislocation associated with a Bennett fracture usually results from a thumb shear mechanism in adduction. Wagner's trapezio-metacarpal pinning reduces dislocation and subsequently stabilizes the joint. Trapezio-metacarpal dislocation associated with a trapezium fracture is usually the result of an axial compression mechanism.

Conclusion: However, the incarceration of capsulo-ligamentous lesions is an indication for open reduction and internal fixation. Apart from intra-articular ligamentous incarceration, reduction by external maneuvers and trapezio metacarpal pinning or inter metacarpal pinning represents the final steps in surgical treatment of trapezio-metacarpal dislocation.

Keywords: Pinning, Trapezium, Dislocation, Trapezio-metacarpien joint.

Citation: Ben Amor Y. “Trapezio-Metacarpal Dislocation: A Rare Lesion: About Two Cases”. SVOA Orthopaedics 2:2 (2022) Pages 35-38.