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To describe a nonsurgical approach for the treatment of an isolated dorsal dislocation of the carpometacarpal joint of the thumb that remained unstable immediately following closed reduction and casting.
An isolated dorsal dislocation of the thumb is an uncommon injury. The dislocation that remains stable following closed reduction has been treated conservatively with immobilization. Dislocations that remain unstable following closed reduction have been stabilized surgically with favorable results.
Materials and application guidelines for a thumb spica cast are presented. Anatomic alignment of the dislocation can be revealed with postcasting radiographs. Possible complications from the immobilization are also presented.
This nonsurgical approach can be used to avoid percutaneous pinning, to return the athlete to competition without loss of playing time, to provide an effective closed reduction, and also to allow full range of motion of the elbow and uninvolved fingers.