A painful hand after a fallBMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h3388 (Published 03 July 2015) Cite this as: BMJ 2015;351:h3388
- Adam Monsell, senior house officer, trauma and orthopaedics1,
- Vipin Asopa, consultant surgeon, trauma and orthopaedics1
- Correspondence to: A Monsell
A 33 year old man presented to his local emergency department after having fallen on to clenched knuckles from standing height. On examination he had a swollen painful right hand⇓. A plain lateral radiograph was taken of the hand⇓. What is the diagnosis?
Carpometacarpal dislocations other than those affecting the thumb are relatively common and can be easily missed.1 This may be a source of litigation.
A step deformity of the dorsum of the hand (as noted in fig 2⇑) is noticed immediately after injury. However, this may become obscured by the development of swelling. A true lateral radiograph of the hand is essential when this injury is suspected.
Cite this as: BMJ 2015;351:h3388
Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: none.
Provenance and peer review: Not commissioned; externally peer reviewed.
Patient consent obtained.