Irreducible fracture dislocation of a finger metacarpophalangeal joint: a case report

Complex dorsal metacarpophalangeal joint dislocation associated with proximal metacarpal fracture: case report and review of the literature

INTRODUCTION

Complex dorsal metacarpophalangeal joint (MCPJ) dislocations are uncommon injuries that mainly affect the index finger and are typically caused by a fall on an outstretched hand. It is exceptional for complex MCPJ dislocation to coexist with a distal fracture of the corresponding metacarpal bone.

PRESENTATION OF THE CASE

The authors report a case of a 23-year-old man presented to the emergency, with a complex dorsal metacarpophalangeal joint dislocation of the index associated with a distal metacarpal fracture confirmed by imaging. The patient had an open reduction and internal fixation of the proximal metacarpal fracture. The results were satisfying.

DISCUSSION

Dorsal MCP joint dislocations are rare, primarily affecting the index and little fingers, and are typically caused by a fall on an outstretched hand. Complex dislocations, characterized by irreducibility, involve structures forming a "noose" around the metacarpal head. Fractures associated with these dislocations are uncommon. Early diagnosis is crucial for better long-term functional outcomes. Radiographic imaging, including three different views, is necessary for accurate diagnosis. Surgery is usually required, with different approaches depending on the case. Arthroscopic techniques can be used when reduction is challenging. Timely surgical intervention yields the best results. Stiffness, osteoarthritis, osteonecrosis, and growth arrest in pediatric cases are the main complications.

CONCLUSION

Complex dorsal metacarpophalangeal joint (MCPJ) dislocations are rare. Open reduction is typically necessary for optimal outcomes. Complications such as stiffness, osteoarthritis can arise, emphasizing the importance of accurate diagnosis and appropriate management.