Dislocation and fracture-dislocation of the carpometacarpal joints

Pure dislocations require immediate reduction and, according to the resulting joint stability, may be treated with splinting or temporary K-wire stabilization.

Fracture-dislocations may involve hamate and capitate fractures which often require fixation.

Bone graft may be necessary in severe comminution of hamate or capitate.

Anatomical reduction is mandatory for good outcome. If closed reduction is not successful, prepare for ORIF.