Application of dorsal supporting plate for treatment of the fourth and fifth carpometacarpal joint fractures and dislocations

Objective To report the clinical efficacy of dorsal lateral supporting plate in the treatment of the fourth and fifth carpometacarpal joint fractures and dislocations. Methods From June 2010 to May 2017, 7 patients with the fourth and fifth carpometacarpal joint fractures and dislocations were treated by dorsal lateral supporting plate and Kirschner wire fixation. The fractures of the hamate bone were all Cain type Ⅱunstable fractures, including 1 case of type ⅡA, 4 cases of type Ⅱ B, and 2 cases of type Ⅱ C. Among them, 2 cases had the base of the fourth and fifth metacarpal bone fractures, and 2 cases had only the base of the fourth metacarpal bone fracture. Results All the wounds achieved primary healing. The fracture healing time ranged from 8 to 12 weeks. The internal fixation was taken out depending on the healing of the fracture. All the patients were follow-up from 5 to 12 months with an average of 7 months. The flexion and extension function of all the hand joints recovered well. According to the upper extremity function evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association, the results were rated as excellent in 4 cases and good in 3 cases. Conclusion The treatment of fractures and dislocations of the fourth and fifth carpometacarpal joints with dorsal supporting plate and Kirschner wire fixation can provide stable fixation in multiple planes and directions, which is helpful for early functional exercise. Key words: Hamate bone; Carpometacarpal joints; Fractures,bone; Dislocations