Dorsal dislocation of the distal interphalangeal joint and volar dislocation of the metacarpophalangeal joint in the same finger: a case report

Open dorsal distal interphalangeal joint dislocations: A report of 20 cases

INTRODUCTION

Several isolated closed dislocations of the dorsal interphalangeal joint are reported, and sometimes they may be associated with other fractures/dislocations. Less is known about the open dorsal dislocation of the distal interphalangeal joint.

HYPOTHESIS

Open dorsal dislocations are stable after reduction and prone to develop dorsal interphalangeal joint stiffness.

METHODS

Twenty patients with open dorsal dislocation were treated by open reduction and volar plate repair. The diagnosis was made, and the displacement was noted. Associated injuries, fractures, and dislocations were also reported. Postoperative x-rays, range of movements, visual analog score, return to work, and functional outcomes were analyzed.

RESULTS

The average follow-up was 23months (range: 19-27months). There were dorso-radial (n=13), dorsal (n=5) and dorso-ulnar (n=2) dislocations. Follow-up with radiographs showed good reduction and congruent distal interphalangeal joint. The mean range of DIP joint movement was 53% (range: 40-65%) and grip strength 70% (range: 50-76%) of the opposite side. The Median VAS score was 0.6 (range: 0-2). Seventeen out of 20 patients who were operated on<8hours of injury had a significant impact on the functional outcome (p<0.05). Three patients who had treatment delay>8hours of injury developed significant postoperative joint stiffness.

DISCUSSION

Adequate debridement and an early open reduction of the dorsal interphalangeal joint dislocation produces stable and congruent joint with good functional outcome and early return to normal activities. Open dislocations do not behave like closed dislocations, and joint stiffness is more common and inevitable.

LEVEL OF EVIDENCE

IV; retrospective case study.

Volar Metacarpophalangeal Dislocation of Fingers: Review of the Literature

Isolated volar metacarpophalangeal dislocations of fingers are extremely rare. There are few cases published in English and French literature. In this article, we aim to review the literature and present a case of isolated open volar dislocation of a finger. We treated this dislocation first by a dorsal approach alone and later, after recurrence, using a combined dorsal and volar approach. This report emphasizes the pathology of such injuries, clarifies the mechanisms, and outlines the treatment options of the dislocations. Close reduction can be achieved and maintained if done early. It must be attempted first for all cases. In irreducible or reducible but unstable dislocations, we recommend surgical restoration. During an open reduction, the major torn or avulsed soft tissue joint stabilizers must be repaired. A combined dorsal and volar approach, starting dorsally, is useful.

Management of Finger Joint Dislocation and Fracture-Dislocations in Athletes

Although finger joint dislocations are generally thought of as benign by many athletes and assumed to be a sprain, these injuries represent a spectrum that includes disabling fracture-dislocations. Failure to recognize certain dislocations or fracture-dislocations may result in permanent deformity and loss of motion. Simple dislocations are frequently amenable to early return to play with protection; however, more complex injuries may require specialized splinting or surgery. Delay in diagnosis of unstable proximal interphalangeal fracture-dislocations may require reconstruction or fusion. Early diagnosis and appropriate treatment are essential to ensure optimal functional results.

Unusual double dislocation of both joints in a same finger: a case report

Simultaneous dislocation of both interphalangeal (IP) joints of same finger is a highly uncommon finding. And dislocation of metacarpophalangeal (MCP) joint along with interphalangeal joints of thumb are reported in literatures if, scarcely. Here we are reporting the three cases, comprising of double dislocation of IP joints in little finger in two patients and simultaneous MCP and IP joint dislocation in thumb in another third patients as a perusal of rare entity from the northern India.