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Carpometacarpal protrusion is a bone mass in the wrist caused by trauma, strain, or congenital condition. Treatment may not be necessary, but anti-inflammatory medication, splinting, and surgery are options. Recurrence is possible, and periodic checkups are recommended.
Carpometacarpal protrusion is the formation of a bone mass in the upper part of the wrist due to trauma, strain, or congenital condition. In some patients it may be benign and require no action unless it grows or starts causing problems. Other patients need treatment to address pain, soreness, or limited joint mobility. Conservative treatment options are successful in many cases, while surgery may be an option if the patient is unresponsive to other treatments.
Some patients are born with carpometacarpal protrusion, while others develop signs of the condition in middle age. Swelling may appear in the wrist, just where the metacarpal bones join. This should feel firm to the touch and may be warm due to inflammation. The condition is sometimes confused with a ganglion cyst, making it important to receive a thorough evaluation to determine the cause of the swelling at the top of the wrist to ensure the patient has the correct diagnosis.
A history of trauma can be a potential indicator, as can repetitive stress. Chronic inflammation around the joint can lead to the formation of a bone spur that grows over time. Basic treatment for carpometacarpal protrusion may include anti-inflammatory medications to reduce swelling and stop growth. Splinting and proper support can also help, especially if repetitive strain is the culprit. Patients who continue to experience pain and stiffness with these measures can discuss more aggressive options.
In surgery, a doctor can remove the spur and smooth the surrounding bone to discourage a recurrence of the condition. Sometimes a ganglion cyst forms next to the carpometacarpal protrusion, in which case it must be removed. While healing, the patient may wear braces to support the joint and aid in recovery. These can be removed once your doctor indicates it’s safe. Periodic checkups may be needed to determine if the bone spur is growing back, which can be a cause for concern in some cases.
People with a history of carpometacarpal protrusion may want to pay close attention to the affected wrist for signs of recurrence as early as possible. Botched surgeries can occur if your doctor can’t remove all of the growth or doesn’t shave the surrounding bone enough. Medications may also fail to suppress a dewclaw return, especially if the patient stops taking them or doesn’t take them regularly. Imaging studies can be used to monitor the carpometacarpal protrusion over time to allow doctors to identify changes that may be cause for concern.
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