A 19-year-old woman presented with left wrist pain over the distal radioulnar joint after falling on her hand. She had no previous history of injury or pain in the hand and no relevant familial history. X-ray examination showed a trapeziometacarpal joint dislocation with a vertical orientation of the trapezium (Fig 1) whereas the right hand and wrist were normal (Fig 2). The patient reported no pain, swelling or limitation of range of motion at the left trapeziometacarpal joint. Clinical examination was normal. The strength of pinch was 5 kg in the left hand and 6 kg in the right, consistent with the fact that she was right-handed. The wrist pain had disappeared by 1 month after the fall and she was able carry out normal daily activities.
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