gms | German Medical Science

Objectives/Interrogation: Treatment of CMC fracture-dislocations is usually surgical and includes open reduction and pinning. Post-operative immobilization is required for several weeks and may result in stiffness and muscular atrophy, which can be detrimental for athletes. This report is a description of a novel treatment (suture tape stabilization) used for a professional basketball player who sustained a fourth metacarpal fracture and concomitant fifth CMC joint dislocation of the dominant hand (Figure 1a [Fig. 1], Figure 1b [Fig. 1]).

Methods: After surgical exposure, the fourth metacarpal fracture was repaired with a plate and screw construct; however, rather than pinning the reduced fifth CMC joint, we proceeded with suture tape stabilization. The tape spanned the fifth CMC joint and was secured with two SwiveLock anchors (Figure 2a [Fig. 2], Figure 2b [Fig. 2]). Stable reduction of the fifth CMC joint was confirmed by fluoroscopy and direct observation.

At three days post-surgery, x-rays revealed a stable plate and screws on the fourth metacarpal and a congruent fifth CMC joint. Physical examination also revealed a stable fifth CMC joint. Hand therapy was initiated. By four weeks post-surgery, he achieved full, pain-free motion of his wrist and fingers. By five weeks post-surgery, grip strength was found to be 96% of the left, non-dominant hand. He was allowed to return to full basketball activities at this time, including dunking.

Results and Conclusions: Suture tape stabilization is a technique where joints are stabilized using synthetic materials. In this elite athlete, this technique allowed for shorter post-operative immobilization and earlier return to sport, without the disadvantages associated with Kirschner wire fixation and post-operative immobilization.