synonyms:CMC fracture dislocation, carpometacarpal fracture, carpometacarpal dislocation, CRPP carpometacarpal fracture, CRPP CMC dislocation, percutaneous pinning CMC dislocation
CMC Dislocation CRPP CPT
CMC Dislocation CRPP Indications
- Dislolcation of the carpometacarpal joint
CMC Dislocation CRPP Contraindications
- Severe soft tissue injury
CMC Dislocation CRPP Alternatives
CMC Dislocation CRPP Pre-op Planning
- Consider pre-op CT scanning
CMC Dislocation CRPP Technique
- Pre-op antibiotics
- Sign operative site
- Anesthesia: LMA vs Bier block
- Prep and drape
- Traction in flexion with simultaneous longitudinal pressure on the dorsally displaced metacarpal base, followed by extension of the metacarpal head when length has been restored.
- Longitudinal and/or oblique K-wire fixation.
- Bend and cut k-wires; pin caps
- Place in anterior and posterior plaster splint
CMC Dislocation CRPP Complications
CMC Dislocation CRPP Follow-up care
- Post-op: Volar plaster splint. is continued for 4 to 6 weeks, at which time the wire is removed. IP and MP joint ROM exercises.
- 7-10 Days: Wound check, repeat xrays to ensure maintenance of reduction. Continue volar splinting. IP and MP joint ROM exercises.
- 4-6 Weeks: Remove K-wires. Progress with ROM.
- 3 Months: Evaluate ROM. Consider OT if motion is poor. Sport specific rehab.
- 6 Months: Return to sport / unlimited activity.
- 1Yr: Follow up xrays, outcome assessment.
CMC Dislocation CRPP Outcomes
CMC Dislocation CRPP Review References