In this paper we report and discuss the management of an extremely rare case of comminuted trapezium fractures associated with Trapeziometacarpal (TMC) joint dislocation. To our knowledge only 2 cases were reported in the literature. Treating such injury is challenging. The aim when treating such fractures is to maintain fracture stability preventing further displacement while maintaining reasonable joint congruity. Although short-term outcomes are satisfactory, it is hard to predict long-term complications.