International Journal of Research in Medical Sciences | April 2016 | Vol 4 | Issue 4 Page 1290 International Journal of Research in Medical Sciences Khan AQ et al. Int J Res Med Sci. 2016 Apr;4(4):1290-1291 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Case Report Pure trapezio-metacarpal dislocation - a rare injury Abdul Qayyum Khan 1 *, Gul Ar Navi Khan 2 , Zafar Ahmad Khan 1 INTRODUCTION Pure trapezio-metacarpal dislocation is a rare hand injury. 1 Epidemiologically, it accounts for less than 1% of all hand traumas. The lesion is usually due to an axial force transmitted through partially flexed thumb, forcing the joint to deflect dorsally. Dislocation occurs in dorsal direction due to volar part of the ligament being thicker and stronger. Optimal treatment strategy for traumatic Trapezio-metacarpal dislocation remains controversial. 2 Closed reduction and cast, open or closed reduction with temporary K-wire fixation, and dorsal capsule and ligament reconstruction have been used to stabilize the joint. However few cases have been reported in the literature. CASE REPORT A 23 years old male presented to emergency department, one hour after sustaining injury to his right thumb, when he fell down from his motorcycle. He fell down on the outstretched hand. Patient felt excruciating pain in the thumb and he was unable to move his right thumb. On examination deformity, fullness and tenderness was present at anatomical snuffbox. Instability was present at 1 st carpo-metacarpal joint. For this X-ray right hand anterioposterior and oblique views were done. This shows trapazio-metacarpal dislocation right hand (Figure 1). Figure 1: Anterioposterior and oblique view of right hand showing carpo-metacarpal dislocation of right thumb. Patient was managed with closed reduction (Figure 2) and thumb spica cast immobilization for 4 weeks ABSTRACT Isolated trapezio-metacarpal dislocation is a rare condition, generally occurs due to fall on outstretched hand. These injuries are sometimes missed in polytrauma patients or sometimes neglected as in underdeveloped world. Various treatment modalities are used, including conservative and surgical options; however no gold standard approach exists for this rare injury. This case report aims to report outcome of a trapezio-metacarpal (TM) dislocation of a patient who was treated conservatively with excellent functional outcome. Keywords: Dislocation, Trapezio-metacarpal, Thumb 1 Department of Orthopaedic Surgery, 2 Deptartment of Physiology, J.N. Medical College, A.M.U., Aligarh, India Received: 09 February 2016 Revised: 09 February 2016 Accepted: 07 March 2016 *Correspondence: Dr. Abdul Qayyum Khan, E-mail: drabdulqayyum@rediffmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160828