Traumatic Dislocation of the First Carpometacarpal Joint in a Skier: A Case Report and Review of the Literature.

Traumatic dislocation of the first carpometacarpal joint is a rare orthopedic injury. It is typically associated with high-energy trauma in young males but can also occur in sporting accidents such as skiing. We present the case of a 30-year-old female skier who sustained a dorsal dislocation of the first CMC joint while skiing. The injury occurred due to a mechanical fall while gripping a ski pole, a mechanism distinct from the typical axial loading seen in other traumas. The dislocation was managed with closed reduction and immobilization in a thumb spica cast. Although standard protocols typically recommend four to six weeks of immobilization to ensure ligamentous healing, the patient independently removed the cast at 21 days post injury. Despite this early removal, clinical and radiographic follow-up at 30 days demonstrated a stable, concentric joint with good functional outcomes and minimal pain. In conclusion, early recognition and anatomical reduction are paramount for the successful management of first carpometacarpal dislocations. While four to six weeks of immobilization remains the standard of care to prevent chronic instability, this case demonstrates that satisfactory stability and function can be achieved with shorter immobilization periods in stable injuries.