Isolated palmar displaced fracture of the base of the index metacarpal: a case report

The current literature contains an abundance of references citing fracture dislocations of the thumb, ring, and small finger carpometacarpal joints, but there are few reports of index and long finger carpometacarpal fractures or fracture dislocations. Isolated injuries of these joints are decidedly rare, and in those instances where fracture dislocations are reported, they are essentially all dorsally directed and usually involve multiple joints. Only four cases of isolated palmar dislocation of the index and long finger carpometacarpal joints have been reported. These reported cases have not documented associated bony fractures, and none involved only the index metacarpal. We present a case of an isolated fracture dislocation of the base of the index metacarpal with displacement of the base fragment into the palm. examination was remarkable for diffuse hand swelling, and a dorsal bony defect was found despite the marked swelling. Additionally, there was an area of tenderness ulnar to the thenar emminence. and attempted flexion of the fingers elicited palmar pain. Anteroposterior and oblique x-ray films showed irregularity of the base of the index metacarpal and a