What's the Diagnosis? By Dr. Loran Hatch

A 35 yo M presents to the ED complaining of R hand pain after punching a wall in an upward motion. He denies any numbness or paresthesias. On exam, he has an obvious deformity of the dorsum of the R hand, but is neurovascularly intact. Xray is shown below.  What's the diagnosis?  (scroll down for answer)



Answer: Carpo-metacarpal dislocation (4th and 5th in this case)