Name of the Procedure:

Closed Treatment of Carpometacarpal Dislocation, Other Than Thumb, with Manipulation, Each Joint; Without Anesthesia

Summary

This procedure involves manually relocating a dislocated carpometacarpal (CMC) joint of the hand (excluding the thumb) without using anesthesia. The treatment is performed by a healthcare professional to ensure the joint returns to its proper position.

Purpose

The closed treatment of a CMC dislocation is used to address a dislocation where the bones are misaligned at the joint connecting the wrist and the base of the fingers (carpometacarpal joint). The goal is to restore normal joint alignment, relieve pain, and maintain or regain hand function.

Indications

• Visible deformity at the base of the affected finger(s)
• Pain and swelling in the area of the dislocation
• Inability to move the affected finger(s) properly
• Trauma or injury to the hand

Preparation

• No fasting or specific pre-procedure medication adjustments are typically required.
• An X-ray or other imaging tests may be conducted to confirm the dislocation and assess any associated fractures or injuries.

Procedure Description

1. The patient is positioned comfortably, typically sitting or lying down.
2. The healthcare provider uses their hands to carefully manipulate the dislocated joint, applying gentle pressure and traction to guide the joint back into proper alignment.
3. No anesthesia is administered for this procedure, although local numbing agents or pain relief medications may be provided as needed.
4. After the joint is realigned, the area may be immobilized with a splint or bandage to maintain the correct position and promote healing.

Duration

The procedure usually takes about 10 to 20 minutes.

Setting

It can be performed in an outpatient clinic, emergency room, or any setting with appropriate medical supervision.

Personnel

• Orthopedic surgeon or emergency physician
• Nurse or medical assistant

Risks and Complications

• Pain or discomfort during and after the procedure
• Swelling and bruising at the manipulation site
• Risk of re-dislocation
• Potential for damage to surrounding tissues or nerves
• Rarely, development of chronic joint instability or arthritis

Benefits

• Rapid relief from pain and discomfort caused by the dislocation
• Restoration of normal joint alignment and function
• Minimal recovery time compared to surgical interventions

Recovery

• Immobilization of the affected area with a splint or bandage as directed by the healthcare provider
• Follow-up appointments to monitor healing progress
• Specific exercises or physical therapy may be recommended to regain full function
• Generally, recovery takes a few weeks, depending on the severity of the dislocation and patient adherence to care instructions

Alternatives

• Open surgical reduction (if closed treatment is not successful)
• Use of anesthesia if pain management is a concern
• Conservative treatments like rest, ice, and anti-inflammatory medications for minor dislocations

Patient Experience

• Patients may feel significant discomfort during manipulation but will often experience immediate relief once the joint is back in place.
• Pain management includes over-the-counter pain relievers and local numbing agents.
• Swelling and mild discomfort are expected during the initial post-procedure period, usually managed with ice packs and elevation.