Double dislocations of digits

Simultaneous extraarticular fracture of the base of the first metacarpal and dislocation of the metacarpophalangeal joint of the thumb: A case report

Double fracture-dislocations of the thumb are rare. Only a single case report of a simultaneous extra- articular fracture of the base of the first metacarpal and dislocation of the metacarpophalangeal joint has been previously reported. We report the second case report of this injury in a 20-year-old man. The patient had an excellent outcome after treatment.

Double Dislocation of Interphalangeal Joints Accompanied with Contralateral Shoulder Dislocation: A Case Report

Dislocation of any joint is an orthopaedic emergency and needs immediate attention by the attending physician. A delay in reducing a dislocated joint can lead to disastrous complications both immediately as well as in the long run. Although anterior dislocation of a shoulder joint is by far the commonest dislocation encountered by any emergency care physician, other joints may also get dislocated. In certain cases two joints may get dislocated simultaneously. Such dislocation is known as a double dislocation. Double dislocation of the proximal interphalangeal joint and the distal interphalangeal joint in the same finger is a rare injury. High impact loading at the fingertip is the primary cause in most cases and it is often associated with younger individuals playing contact sports. The right little finger is the digit commonly involved and this injury is evident in football players more often than not. Although closed reduction is a preferred treatment, it may not be always successful. Time of presentation, tendon interposition, associated swelling and co-existent phalangeal fractures are certain key impediments to a successful closed reduction manoeuvre. In patients with an open injury, a thorough wash out and appropriate antibiotic cover is mandatory. We report a rare case of double dislocation of the interphalangeal joints accompanied with contralateral shoulder dislocation in an elderly man sustained after a fall which was treated successfully with closed reduction and early mobilization.

Simultaneous dislocation of both the proximal and distal interphalangeal joints of a little finger

A 39-year-old man fell at work sustaining dislocation of both the proximal and distal interphalangeal joints of his left little finger. The injuries were assessed and treated with closed reduction and stabilised by buddy taping. Early active range of movement was encouraged and a referral to physiotherapy was made. At the final follow-up, 4 months after the injury, he lacked subtle end of range movement actively, but functionally he was coping well and had made a full return to work.

Floating thumb with double dislocation of carpometacarpal and metacarpo-phalangeal joints

INTRODUCTION

Double dislocations of carpometacarpal and metacarpo-phanlageal joints are rare. We report an unusual case of simultaneous dislocation of both CMC and MCP joints in the thumb.

PRESENTATION OF CASE

A 31 year old male was admitted following a road traffic accident. He was complaining of pain and deformity of right thumb. The X-ray examination revealed simultaneous dislocation of both CMC and MCP joints. He underwent closed manipulative reduction and percutaneous K wire fixation. The wires were removed after six weeks. After a course of physiotherapy he regained full range of pain free movements.

DISCUSSION

The incidence of simultaneous dislocation of both CMC and MCP joints in thumb are associated with high energy injuries. The options of treatment are conservative with cast immobilisation and serial X-rays or operative including closed manipulative reduction and K wire fixation or open reduction and internal fixation.

CONCLUSION

The option of treating this rare injury with closed manipulative reduction and percutaneous K wiring gives excellent and predictable results.

Simultaneous double interphalangeal joints dislocation in a finger in a teenager

BACKGROUND

Simultaneous dislocation of the proximal and distal interphalangeal joints of the same finger is a rare event. In literature simultaneous double interphalangeal dislocation in the same finger has been reported only one case in a skeletally immature patient which was a fourteen year old male. Our case was twelve years old which is the youngest case in the literature that has been reported.

CASE DESCRIPTION

A 12-year-old male injured his right ring finger while playing football. Examination revealed a stepladder deformity. There was no sign of neurovascular damage. Radiographs showed dorsal dislocation of both the proximal and distal interphalangeal joints. Reduction of the double dislocation was easily achieved by simple longitudinal traction. The finger was splinted in the intrinsic plus position for 3 weeks and active range of motion was then allowed.

LITERATURE REVIEW

The most prevalent cause of injury was a sport accident. The left hand was less often involved than the right hand. The finger most often injured was the little finger followed by the ring finger, middle finger and the index finger. Closed reduction is the treatment of choice if there is no soft tissue interposition that prohibits the procedure. In most cases, longitudinal traction was sufficient for closed reduction.

CLINICAL RELEVANCE

We report the second case of simultaneous proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints dislocations in one finger in a 12-year-old non-athletic boy; which is the youngest case in the literature, managed by closed reduction and early mobilization, with excellent outcome.

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.

Double dislocation of finger interphalangeal joints

A 62-year-old, right-hand-dominant man who had dementia and lived in an Elderly Mentally Infirm (EMI) nursing home was admitted through Accident & Emergency (A&E) department following unwitnessed injury to the left little finger. His examination revealed a swollen and deformed left little finger with a laceration along the middle crease on the volar aspect and head of proximal phalanx visible through this. Distally sensations and capillary refill was normal. X-rays showed a double dislocation of both proximal and distal interphalangeal joints. The finger was reduced under ring block and the laceration was washed with saline in A&E. The patient was taken to the operation theatre next morning for wound exploration and wash-out±stabilistion of the finger under general anaesthesia. The wound was thoroughly washed out and closed with 4/0 interrupted nylon. The finger was immobilised with neighbour strapping and bandaged in flexion.

IRREDUCIBLE SIMULTANEOUS DISLOCATION OF BOTH INTERPHALANGEAL JOINTS IN THE LITTLE FINGER: A CASE REPORT

We present a case with irreducible simultaneous dislocation of both the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints in the little finger. A combination of the delay from injury to closed reduction and the entrapped flexor digitorum profundus (FDP) tendon at the PIP joint prevented closed reduction from being performed. To our knowledge, this is the first report of such a condition.

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

Double dislocations of the finger interphalangeal and/or metacarpophalangeal joints are a rare entity. Sixty-four cases of distal and proximal interphalangeal joint double dislocations have been previously reported. Five cases of metacarpophalangeal and interphalangeal double dislocations of the thumb have also been reported. Only one case has been reported in the English literature regarding simultaneous dislocations of the distal interphalangeal and metacarpophalangeal joints in the nonthumb digit. The directions of the dislocation were the same; both were dorsal. We report, to our knowledge, the first ever case of a double dislocation a non-thumb digit in opposing directions-volar at the metacarpophalangeal joint and dorsal at the distal interphalangeal joint.

Simultaneous double dislocation of the interphalangeal joint in a finger

Isolated traumatic dislocation of the distal and proximal interphalangeal joints of the fingers is a common occurrence. However, simultaneous dislocation of both interphalangeal joints in a single finger appears to be a rare event. We report five cases of simultaneous dislocation of both interphalangeal joints in a single finger with a review of the literature.

[Double dislocation of the interphalangeal joints of the little finger, a report of two cases]

Two cases of simultaneous traumatic dorsal dislocation of the interphalangeal joints of the little finger are described. In both cases the patients were managed by closed reduction and neighbour strapping followed by immediate mobilisation. At review, no complications were noted. The range of movements of all the affected joints was normal.

Simultaneous double interphalangeal dislocation in a finger

A rare case of simultaneous dorsal dislocation of both interphalangeal joints in a finger is presented. Review of reported cases revealed that this injury usually occurs on the ulnar side of the hand of young male athletes and has a good outcome with conservative treatment.

Transverse bayonet dislocation of the distal interphalangeal joint--a case report

Transverse bayonet dislocation of an interphalangeal joint is an unstable injury caused by the disruption of both collateral ligaments. This injury pattern in proximal interphalangeal joint was first described by Patel et al. (Clin Orthop Rel Res. 1978;133:219), who coined the term "bayonet dislocation" to describe this particular type of injury. The case of a distal interphalangeal transverse dislocation is presented. This dislocation was successfully treated by closed reduction and immobilization with an aluminum splint and buddy taping to the adjacent finger.