Carpometacarpal (CMC) joint dislocations of the fingers are uncommon injuries [
1]. These injuries mainly occur in young adults and represent less than 1% of all lesions of the hand [
2]. Simultaneous CMC dislocations may be dorsal and volar. Dorsal dislocations are more frequent [
3]. The reason why dorsal dislocations are commoner is that stronger static (dorsal ligaments) and dynamic (wrist extensors) restraints may cause the failure of bone dorsally, with the subsequent rupture of the volar ligaments [
4]. The increased mobility on the ulnar side may predispose to the known greater frequency of the injury. Stability at the finger CMC joints is provided by a system of four ligaments, namely the dorsal metacarpal, the palmar metacarpal, and the two sets of interosseous ligaments. Divergent varieties are exceptional being the result of a compound traumatic mechanism [
5]. The diagnosis of this unusual form of injury requires a high index of suspicion, vigilant examination, and high quality radiography. CMC joint fracture dislocation can be treated by closed reduction immobilization, closed reduction internal fixation, or open reduction internal fixation with Kirschner (K) wires. However, in cases of closed reduction, there is a higher risk of radiolocation of the CMC joint, as compared to open reduction. Open reduction and internal fixation is the recommended treatment for CMC joint dislocation [
6]. Due to severe swelling and overlapping of bones on radiographs of wrist and hand, dislocations are missed.
We report the case of a 24-year-old man who presented a CMC fracture-dislocation of the four last fingers of his right hand following a fall in a national cycling competition who had received emergency treatment.