Complex multiple Metacarpo phalangeal joint dislocation. Is closed reduction, a good treatment option? (original) (raw)
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Journal of Orthopaedic Case Reports, 2016
Introduction: Multiple simultaneous dislocations of the metacarpophalangeal joints are exceedingly rare. Five cases only were described in the English literature. Only one case necessitated open reduction. A case of simultaneous open and closed dislocation of ipsilateral four metacarpophalangeal joints is presented. The case had a delayed presentation (8 days following the trauma) and needed open reduction. Case presentation: A 33-year-old manual worker sustained dislocation of the ulnar four metacarpophalangeal joints of his non dominant hand. The hand injury was missed for eight days. The injury was successfully managed by open reduction. The patient regained near normal functional outcome. Conclusion: Open reduction may be needed for these injuries. Prompt intervention and early rehabilitation are needed for satisfactory outcome.
A rare case of closed isolated dislocation of the third metacarpophalangeal joint of the hand
Journal of clinical orthopaedics and trauma, 2013
Metacarpophalangeal joint [MCP] dislocations of the index, little and thumb are common; that of the middle finger is very rare. In all the literature consulted only five cases of isolated closed dorsal dislocation of the MCP joint of the middle finger have been reported. Hyperextension of MCP joint is the mechanism of injury. We are herewith reporting a case of isolated MCP dislocation of the middle finger. One of our medical students while driving a motorcycle fell down on the road and sustained lacerated wound over the hypothenar area of the left hand. There was prominence of the head of the third metacarpal on the volar aspect and the base of the proximal phalanx was prominent dorsally. MCP dislocation of the middle finger was our clinical diagnosis which was confirmed by the radiograph. The patient had reported within 60 min of the accident. There was no tendon injury. Wound debridement was done, wound was extended to the back of the middle finger. The volar plate which was interposed between the head of the metacarpal and the base of the proximal phalanx was repositioned and the dislocation was reduced. Reduction was stable and the patient was reviewed after 14 months. The function of the hand is satisfactory. The case is presented for its unique presentation. This is the sixth case of isolated dislocation of the MCP joint of the middle finger.
Percutaneous Technique for Reduction of Complex Metacarpophalangeal Dislocations
Annals of Plastic Surgery, 2004
Historically, complex metacarpophalangeal (MCP) joint dislocations have necessitated open surgical management by either a volar or dorsal approach. The authors describe a relatively simple and reliable percutaneous technique to treat these complex MCP dislocations, with results comparable with open surgical reduction. This minimally invasive technique can be performed in the emergency room setting, thereby avoiding the cost and morbidity associated with an open procedure in the operating room. From 1996 to 2003, the percutaneous technique was performed on 4 patients with complex MCP joint dislocations. Three patients underwent percutaneous reduction in an operating room whereas the fourth patient was reduced in the emergency room. Successful reduction was attained on the first attempt in all 4 patients without complications. All dislocations were stable after reduction. Near full, painless range of motion was achieved in all 4 patients and there were no cases of recurrent instability. All patients were satisfied with their results.
New approach to second metacarpophalangeal joint dislocation management: the SKY needling technique
European Journal of Orthopaedic Surgery & Traumatology, 2020
Second metacarpophalangeal dislocation is a rare entity, wherein correct diagnosis can be achieved by careful and experienced clinical examination that must be followed by radiological examination. This mostly requires open reduction either by dorsal or volar approach. Open reduction by volar approach is being used most widely but has more incidence of postoperative loss of sensation at volar aspect of finger due to neurovascular injury (digital nerve and vessel) and also required more extensive dissection. Dorsal approach is a rather safe alternative to volar approach as it provides better exposure to volar plate. We present a new technique wherein the chances of neurovascular injury are very rare and make it an effective and less complicated surgery.
The musculoskeletal injuries of hand require meticulous handling and appropriate intervention for optimal outcome. The open metacarpo-phalangeal (MCP) dislocations are rare injuries with high dependence on early adequate management and early rehabilitation to ensure good function and dexterity. The delicate soft tissue handling and adherence to principles of antisepsis prove instrumental in standard treatment protocol. The MCP dislocations have been studied and reported extensively with other associated injuries or in isolation. The presented report underlines a rare occurrence of simultaneous three MCP dislocations in a hand with an open palmar wound managed accordingly with satisfactory outcome.
Dorsal Approach for Dorsal Complex Metacarpophalangeal Dislocation of the Index Finger
Jordan Medical Journal, 2012
Dorsal complex dislocations of metacarpophalangeal joints are a rare injury. Various anatomical structures have been blamed to preclude closed reduction and controversy also exists regarding the ideal approach. We reviewed 5 patients whom we treated with open reduction via the dorsal approach, and we had consistently good results.
International Journal of Advanced Research (IJAR), 2018
Dorsal dislocation of the metacarpophalangeal joint of the thumb is uncommon.complex dislocations occur most commonly in index finger followed in incidence by thumb & small finger &, rarely, long & ring fingers.Complex dislocations are described as dislocations that are irreducible ,infolding of the proximally disrupted volar plate between metacarpal head and base of proximal phalanxand often require surgical intervention because the thumb MP joint, anatomical structures that may become entrapped include the volar plate, sesamoid bones, bony fracture fragments or the flexor pollicislongus tendon. A case report on the post traumatic , complete complex dorsal dislocation the thumb is surgically treated on volar approach is presented .
Dorsal dislocation of the first metatarso-phalangeal joint. Report of four cases
The Journal of bone and joint surgery. British volume, 1975
The anatomy of the first metatarso-phalangeal joint and of dorsal dislocation of the phalanx are described. As similar lesions in the hand, closed reduction is impossible because of interposition of the volar plate. Open reduction is essential and should be performed as soon as possible after the injury.