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Metacarpophalangeal Joint Dislocation
From WikiSM
Other Names
- MCP Joint Dislocation
- MCP Dislocation
Background
- Traumatic injury to Metacarpophalangeal Joint
Pathophysiology
- Typically a fall on outstretched hand with hyperextension mechanism
- Dorsal dislocation more common than volar dislocation
Risk Factors
- Unknown
Differential Diagnosis
- Fractures
- Dislocations
- Tendinopathies
- Ligament Injuries
- Neuropathies
- Arthropathies
- Nail Bed Injuries
- Pediatric Considerations
- Other
Clinical Features
- General: Physical Examination Hand
- Inspection: Deformity generally obvious
- Dorsal: hyperextended proximal phalanx with flexion at PIPJ
- Volar: loss of extension, dorsal skin depression
Evaluation
Classification
- Anatomic
- Volar
- Dorsal (more common)
- Complexity
- Simple: no interposition of Volar Plate, sesamoids
- Complex: interposition of volar plate and/or sesamoids
- metacarpal head becomes entrapped by displaced ligaments
- Kaplan's lesion: rare, metacarpal head buttonholes volarly into palm
- Most common in index finger
Management
Acute Management
- Reduction: May reduce with just traction
- Dorsal dislocation:
- Relax flexor tendons by flexing wrist
- Then hyperextend the joint and apply dorsal pressure over the roximal phalanx in distal and volar direction
- Volar dislocation:
- Less common, harder to reduce with closed reduction
- Hyperflex the joint and then apply traction and extend finger
- Guide proximal phalanx into place
- Splint with MCP joint in flexion
Nonoperative
- Closed reduction for simple dislocations
Operative
- Open reduction for complex dislocations
Return to Play
- Needs to be updated
Complications
See Also
External
- Sports Med Review Hand Pain: https://www.sportsmedreview.com/by-joint/hand/
References
Created by:
John Kiel on 18 June 2019 23:09:24
Authors:
Last edited:
16 October 2022 00:16:47
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