4th carpo-metacarpal joint dislocation

[medstudent171]

I have a 4th carpo-metacarpal joint dislocation. My question is this;

How long can I safely wait before getting K wires inserted? It happened 3 days ago now but due to doctor incompetencies it was only diagnosed a few hours ago. I'm currently staying with my girlfriend and the doctors here (london) said the orthopaeds won't look at me here as I live else where. Basically I don't want to cut my visit short to go home (belfast), so if any orthos out there can advise, that'd b great!

[S. Kaul, MD]

Hi there!

Though there is no specified time limit for putting in the K-wires, the earlier the better. Old injuries do not heal as good as new injuries, still older injuries (more than 2 months or so) do not heal with the desired results and hence doctors do not like to operate on the old injuries. Typically I would like to see the K-wires in, within a week. Also dislocated joints may require a reduction before the K-wires can be put in. The K-wires would be left in typically for 6-8 weeks, till the injury has healed.
Hope this helps.

Take care!

[usarmymedic1]

just say this if you don't get the K wires you will have a losey goosey joint meaning it will be easier to dislocate agian. most surgeouns don't like operating on old injuries unless it needs to be done. this being 8 days from dislocation and if they wanted to put in K wires that must mean they feel like you tore legaments that stablize the 4th CMC. this could cause you more pain in the futrue by the means of osteo-arthritits. You should be wearing at least a splint to decrease the chance of redislocating it