Simultaneous dislocation of the interphalangeal and metacarpo-phalangeal joints in a thumb

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.

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.

Palmar dislocation of the thumb metacarpophalangeal joint: report of four cases and a review of the literature

We report four cases of palmar dislocation of the thumb metacarpophalangeal joint and review of an additional 22 cases in the literature. Our four cases were associated with ligamentous injuries that prevented stable closed reduction. The patients were treated with open reduction and ligament repair and ultimately had a decreased range of motion. Our four cases and the 22 cases from literature fall into three types: Type A - stable joint (the metacarpophalangeal joint is stable, without severe ligament injury); Type B - tendon block (palmar displaced extensor tendons within the metacarpophalangeal joint prevents reduction); and Type C - joint instability (the metacarpophalangeal joint is unstable because of severe collateral ligament disruption). Type B is the most commonly reported type of palmar dislocation of the thumb metacarpophalangeal joint, with distinct features of the involvement of the collateral ligaments and failure of attempted manual reduction. The patients without severe collateral ligament disruption were managed with conservative treatment. The patients with interposition of extensor tendons and the patients with instability resulting from severe ligamentous injuries require surgical treatment.

Closed reduction and treatment of 2 volar thumb metacarpophalangeal dislocations: report of 2 cases

Volar dislocation of the metacarpophalangeal joint of the thumb may be irreducible by closed means. We describe 2 patients with volar dislocation of the thumb metacarpophalangeal joint treated with closed reduction and casting.

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 Dislocation of the Carpometacarpal and Metacarpophalangeal Joints of the Thumb in a Motorcyclist

Combined dislocation of more than one joint in a single finger is a rare injury. An amateur motorcyclist sustained simultaneous closed dislocation of the carpometacarpal and metacarpophalangeal joints of the thumb as an isolated injury after falling from his motorcycle during an abrupt stop from high speed. The dislocated joints were reduced by closed means on the day of injury. After 18 months, the functional result of his right thumb was excellent. The mechanism of injury and management of this uncommon motorcycle injury is reported.

Chronic volar dislocation of the metacarpophalangeal joint of the thumb: a case report and review of the literature

A 61-year-old man sustained a chronic volar dislocation of the metacarpophalangeal joint of the thumb. He did not present for treatment until he experienced recently progressive joint pain 2 year after injury. Arthrodesis of the metacarpophalangeal joint was performed to correct the deformity of the thumb because of its extensive tissue scarring and erosion of the articular cartilage of the metacarpal head. Six weeks of splint immobilization followed by a physiotherapy program allowed the patient to resume his daily activities with his right hand.

Two cases of closed dislocation of the interphalangeal joint of the thumb

Dorsal dislocation of the interphalangeal (IP) joint of the thumb is a rare injury, and closed dislocation without fracture is especially unusual. We present here two cases of closed dislocation of the thumb which were reduced by manipulation.

Double dislocations of digits

We report eight patients who sustained simultaneous dislocations of two joints in a digit. The little finger was involved in five patients.

Simultaneous open dislocation of the metatarsophalangeal and interphalangeal joints of the hallux: a case report

Simultaneous open dislocations of the hallux metatarsophalangeal and interphalangeal joints is previously unreported. Reducibility of the isolated metatarsophalangeal joint dislocation is often implied by the sesamoid separation and/or the existence of a sesamoid fracture. In the open dislocations of the metatarsophalangeal and interphalangeal joints of the hallux reported in this article, the ease of reduction is related instead to the severe disruption of the capsule.