Complex Dorsal Metacarpophalangeal Dislocation of Index Finger- A case report

Abstract

Complex posterior metacarpophalangeal dislocations of the long fingers are rare, typically caused by entrapment of the volar plate within the joint space. They require surgical reduction to release the soft tissues interposed between the metacarpal head and the proximal phalanx. but there is an operative risk of digital nerve injury because of intricate displacement of the normal anatomy. We report the case of a 30-year-old patient who presented to the emergency department at the second day after his trauma with a complex posterior metacarpophalangeal dislocation of the right index finger. After failure of the closed reduction attempt, the dislocation was reduced surgically by an volar approach. The neurovascular bundle has been identified and carefully removed. The volar plate has been reduced, resulting in reduction of the dislocation. The volar plate has been completely repaired. At six weeks, all the range of motion of the MCP and other joints of the index finger had been found. At the last follow-up, the joint was still stable. Different techniques are described in the literature for the reduction of the complex posterior dislocations of long fingers, but the volar approach remains the best for palmar plate reduction and its full repair, which may decrease the risk of late instability.