4th and 5th carpometacarpal joint dislocations
Bar fight. Boxer's fracture?
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Disruption of the normal carpometacarpal arc on the frontal x-ray at the level of the 4th and 5th rays. The metacarpal bases are superimposed over the distal carpal row. Lateral view confirms dorsal dislocation of the 4th and 5th carpometacarpal joints.
Subtle findings on the frontal x-ray but this case serves as a reminder to review the carpal arcs.