Open dislocation of fourth and fifth carpometacarpal joint – An easily missed injury

Except for the thumb, fractures and dislocations of the carpometacarpal (CMC) joints are a relatively uncommon pattern of injury, and are usually due to high energy trauma. These injuries account for less than 1% of injuries affecting the hand.1,2 These injuries are often missed initially even by orthopedic surgeon, because of the diffuse hand swelling obscuring deformity and misinterpretation of subtle radiographic features as normal.3 Hence, diagnosis requires a high index of suspicion and good-quality radiographs.