Carpometacarpal Fracture-Dislocation CRPP 26676

synonyms:CMC fracture dislocation, carpometacarpal fracture, carpometacarpal dislocation, CRPP carpometacarpal fracture, CRPP CMC dislocation, percutaneous pinning CMC dislocation

 CMC Dislocation CRPP CPT

• 26676
• See all CMC CPT options

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
• 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

• Rockwood, Green, and Wilkins' Fractures in Adults
• Green's Operative Hand Surgery, 2-Volume Set, 7e