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Case Reports
. 2011 Winter;19(4):139-42.
doi: 10.1177/229255031101900406.

Late presentation of a complete complex thumb metacarpophalangeal joint dislocation: A case report

Arash Izadpanah  1 , Kyle Wanzel
Affiliations
Case Reports

Late presentation of a complete complex thumb metacarpophalangeal joint dislocation: A case report

Arash Izadpanah et al. Can J Plast Surg. 2011 Winter.

Abstract
in English, French

Metacarpophalangeal (MP) joint injuries and dislocations of the fingers and thumb are not uncommon. They can be classified directionally as either being volar or dorsal, and are further categorized as incomplete, simple complete or complex complete. Complex dislocations are described as dislocations that are irreducible and often require surgical intervention. This is often because tissue has become entrapped within the MP joint, precluding its anatomical reduction. For the thumb MP joint, anatomical structures that may become trapped include the volar plate, sesamoid bones, bony fracture fragments or the flexor pollicis longus tendon. Both dorsal and volar surgical approaches have been described, and their relative merits will be discussed. The unusual case of a late presentation (two months postinjury) of a complex complete dorsal dislocation of the thumb MP joint approached from a dorsal incision is presented.

Les lésions des articulations métacarpophalangiennes (MP) et les dislocations des doigts et du pouce ne sont pas rares. On peut les classer selon leur orientation palmaire ou dorsale ainsi que comme incomplètes, simples complètes ou complexes complètes. Les dislocations complexes sont décrites comme des dislocations impossibles à réduire, qui exigent souvent une intervention chirurgicale parce les tissus sont coincés dans l’articulation MP, ce qui en empêche la réduction anatomique. Pour ce qui est de l’articulation MP du pouce, la plaque palmaire, les os sésamoïdes, des fragments osseux de fracture et le tendon long fléchisseur du pouce peuvent se trouver coincés. Il existe des méthodes chirurgicales dorsales ou palmaires, et leurs avantages relatifs sont exposés. Les auteurs présentent le cas inhabituel d’un patient qui a consulté à cause d’une dislocation dorsale complète de l’articulation MP du pouce deux mois après sa survenue, laquelle a été traitée par incision dorsale.

Keywords: Complex joint dislocation; Irreducible dislocation; Metacarpophalangeal joint; Open reduction; Surgical approach.

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Figures

Figure 1
Figure 1
Right thumb anteroposterior (A) and lateral (B) radiographs at presentation demonstrating a complex complete dorsally dislocated metacarpophalangeal joint. Note the excessively widened metacarpophalangeal joint space and possible sesamoid bone within the joint space on the lateral x-ray
Figure 2
Figure 2
The dislocated thumb metacarpophalangeal joint is visualized through a dorsal approach. Note the base of the proximal phalanx lying completely dorsal to the metacarpal head. The entrapped volar plate is seen between the two bones and has been split longitudinally, with the radial half being grasped with forceps
Figure 3
Figure 3
The thumb metacarpophalangeal joint was reduced after releasing the entrapped volar plate, splitting it longitudinally and allowing it to slip back to its anatomical position volar to the metacarpal head
Figure 4
Figure 4
Lateral view (A) and anteroposterior view (B) of intraoperative fluoroscopy after open reduction of the complete complex right thumb metacarpophalangeal joint dislocation showing congruous anatomical reduction of the joint
See this image and copyright information in PMC

References

    1. Lourie GM, Gaston RG, Freeland AE. Collateral ligament injuries of the metacarpophalangeal joints of the fingers. Hand Clin. 2006;22:357–64. - PubMed
    1. Zemel NP. Metacarpophalangeal joint injuries in fingers. Hand Clin. 1992;8:745–54. - PubMed
    1. Melone CP, Jr, Beldner S, Basuk RS. Thumb collateral ligament injuries. An anatomic basis for treatment. Hand Clin. 2000;16:345–57. - PubMed
    1. Posner MA, Retaillaud JL. Metacarpophalangeal joint injuries of the thumb. Hand Clin. 1992;8:713–32. - PubMed
    1. Kaplan EB. Dorsal dislocation of the metacarpophalangeal joint of the index finger. J Bone Joint Surg Am. 1957;39:1081–6. - PubMed

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