PMC6311754_01
Apparent shortening of the fourth and fifth rays. (a) Mild swelling of the fourth and fifth CMC joint region, and (b) a bony prominence was felt dorsally.
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fig1
Furthermore, there was apparent shortening of the fourth and fifth rays (Figures 1(a) and 1(b)).
Anteroposterior (a), lateral (b), and internal oblique (c) radiographs of the right hand showed dorsal dislocation of the fourth and fifth CMC joints, without fracture.
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fig2
Anteroposterior, lateral, and internal oblique radiographs of the right hand showed dorsal dislocation of the fourth and fifth CMC joints, without fracture (Figures 2(a)-2(c)).
A 1.5 mm fixator pin was inserted from the base of the fifth metacarpal to the third metacarpal transversally (a). Another 1.5 mm fixator pin was inserted from the ulnar base of the fifth metacarpal to the hamate bone obliquely (b). The external ends of the two pins were bent so that they became parallel. The parallel ends of the two pins were then inserted in a metal clamp from the opposite sides (c).
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fig3
After closed reduction, a 1.5 mm fixator pin was inserted from the base of the fifth metacarpal to the third metacarpal transversally (Figure 3(a)). Another 1.5 mm fixator pin was inserted from the ulnar base of the fifth metacarpal to the hamate bone obliquely (Figure 3(b)). The parallel ends of the two pins were then inserted in a metal clamp from opposite sides (Figure 3(c)).
After fluoroscopic assessment, the ends of the two pins were fixed firmly together using a clamper. A true dorsal view (a) and an ulnar oblique view (b) of the right hand are shown.
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fig4
After fluoroscopic assessment, the ends of the two pins were fixed firmly together using a clamper (Figures 4(a) and 4(b)).
Total extension (a) and total flexion (b) of the right hand on a true dorsal view and total extension of the right hand on an ulnolateral view (c).
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fig5
The grip strength and total active motion were 102% and 101%, respectively, compared with the contralateral side (Figures 5(a)-5(c)).