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DOCTOR CARMES
HAND CENTER
CLINIQUE DES EAUX CLAIRES
GUADELOUPE
1- DORSAL THUMB DISLOCATION
Rare
Pain
Functional limitation
Thumb in hyper-extension
Pain
Functional limitation
Thumb is no more
extended but parallel to
the metacarpal. The MP
joint deformity is minimal
Close reduction of this dislocation is easier if the insertions of the thenar muscles on the sesamoids are intact as
they serve as a guide for the solar plate to get back into its initial position (Weeks 1981)
No traction in the thumb axis
sesamoids will interpose into the
joint
TESTING AFTER REDUCTION IS MADE
IN THE TWO PLANES
In the frontal plane
Volar plate
3: metacarpal-sesamoid lgt
4: phalangeal-sesamoid lgt
5: Sesamoid
Rupture of the
Rupture of the phalangeal-
active sling
sesamoid ligament
Fracture of a sesamoid
Evaluation of the
necessity for surgery
RUPTURE OF THE PHALANGEAL-
SESAMOID LIGAMENT
Sesamoids do not follow the base
of the phalanx in extension
FRACTURE OF A SESAMOID BONE
Difficult to see !
The name sesamoid comes from the greek, it is the flat and oval sesame plant
seed, an Indian plant used by the physicians as a purgative
TWO TYPES OF SESAMOID FRACTURE
Rare injuries
MARIA
hurricane
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