STABILIZATION OF ULNAR CARPOMETACARPAL DISLOCATIONS OR FRACTURE-DISLOCATIONS

For the management of ulnar carpometacarpal dislocations or fracture d islocations, various authors have suggested closed I eduction and perc utaneous pin fixation, or open reduction and internal fixation with th e use of transversely oriented pins, The methods carl be problematic w ith failure of fixation or injury to tendons or ner-ces, A stable inte rnal fixation alternative uses intramedullary metacarpal Steinmann pin s of Kirschner wires, passed across the carpometacarpal joint into tir e hamate, Tf tile fixation devices exit through the triquetrum and the lunate, then the finger metacarpal phalangeal joints may be left with full active motion. This method has provided ease of placement, stabi lity, and no loss of fixation in 9 cases. An associated coronal fractu re of the hamate mag he fixed with small Kirschner wires or with a sma ll lag screw, which can be placed through the same incision.