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Carpometacarpal Fracture-Dislocation CRPP 26676

 
CPT Coding Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

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

  • Closed treatment
  • ORIF

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
  • Dressing
  • 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