2nd to 5th Carpometacarpal joint dislocation combined with extensor carpi radialis longus tendon stop rupture: a case report and literature review

Background: Multiple carpometacarpal joint dislocations are among the rarer injuries with a limited number of associated case reports. Currently, most clinical reports focus on single joint dislocations, while reports of multiple carpometacarpal dislocations with rupture of the extensor carpi radialis longus tendon stop are rare. Case presentation: In this article, we report a case of a 35-year-old male patient, who sustained dislocations of the 2nd to 5th carpometacarpal joints of his left hand due to a car accident. He underwent incisional reduction and internal fixation, during which a rupture of the extensor carpi radialis longus tendon stop was detected and repaired. Postoperatively, the joint was successfully maintained in its original position without subluxation, and rehabilitation exercises were initiated gradually after pain relief the day following surgery. At the last follow-up visit two months post-surgery, the patient exhibited good flexion and extension function of the finger joints. Discussion and conclusion: Multiple dislocations of the carpometacarpal joints are often accompanied by avulsion fractures of the carpal bones and the bases of the metacarpal bones. The base of the second metacarpal bone, which serves as the attachment point for the radial extensor carpi radialis longus tendon, can be fractured by the pulling force. This type of injury is associated with significant hand swelling, increasing the risk of underdiagnosis and misdiagnosis. The purpose of this article is to share a case of 2nd to 5th carpometacarpal joint dislocation with extensor carpi radialis longus tendon stop rupture to provide a reference for clinical management.