The finger CMC joints increase in mobility from index (virtually immobile keystone) to little finger (20 degrees of flexion enabling a deeper grip). The index CMC is the rigid reference point of the hand. The hamate provides the joint surface for the ring and little finger metacarpals — hamate body fractures disrupt these joints producing CMC subluxation.
Little finger CMC fracture-dislocation from axial loading (boxer's injury mechanism) produces the classic reverse Bennett fracture (hamate articular fragment retained by the dorsal CMC ligament while the metacarpal shaft displaces). ORIF or percutaneous fixation restores CMC joint congruence.
Little finger CMC fracture-dislocation from boxing-type impact managed with ORIF or percutaneous fixation to restore the hamate-metacarpal articular congruence.
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